Publications by authors named "Elena Cavallini"

38 Publications

Closeness to friends explains age differences in positive emotional experience during the lockdown period of COVID-19 pandemic.

Aging Clin Exp Res 2021 Jul 11. Epub 2021 Jul 11.

Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 6, 27100, Pavia, Italy.

Background: Studies on age differences in emotional states during the COVID-19 pandemic showed that older adults experienced greater emotional wellbeing compared to younger adults. We hypothesized these age differences to be related to the perception of closeness to family/friends or the engagement in daily activities during the pandemic.

Aim: To investigate age differences in positive and negative emotional experiences and whether the perception of closeness to family/friends and the engagement in daily activities during pandemic explained such age-related differences.

Methods: Through a cross-sectional study, 1,457 adults aged 18-87 years old completed an online survey assessing positive and negative emotional experiences, the perception of more closeness to family/friends, and daily activities that participants started/re-started during the pandemic.

Results: Increasing age was associated with more positive and less negative emotional experiences. Age differences in positive emotional experience were explained by the perception of more closeness to friends and not by the engagement in daily activities. For negative emotional experience age, differences remained significant even after accounting for the perception of closeness to family/friends and engagements in daily activities.

Discussion: Older adults' greater overall level of positive emotional experience was explained by their greater perception of more closeness to friends. We speculate that social closeness provides a coping mechanism to increase emotional wellbeing employed especially in older adults.

Conclusion: Our findings reinforce the link between perceived social closeness and emotional wellbeing especially in older adults. To cope with stressful situation, it is important to encourage older adults to increase the closeness to their social network.
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http://dx.doi.org/10.1007/s40520-021-01927-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272682PMC
July 2021

A double-blind randomized controlled trial combining cognitive training (CoRe) and neurostimulation (tDCS) in the early stages of cognitive impairment.

Aging Clin Exp Res 2021 Jun 22. Epub 2021 Jun 22.

IRCCS Mondino Foundation, Via Mondino 2, Pavia, Italy.

Background: The prevalence of neurodegenerative diseases is expected to increase over the next years, therefore, new methods able to prevent and delay cognitive decline are needed.

Aims: To evaluate the effectiveness of a combined treatment protocol associating a computerized cognitive training (CoRe) with anodal transcranial direct current stimulation (tDCS).

Methods: In this randomized controlled trial, 33 patients in the early stage of cognitive impairment were assigned to the experimental group (CoRE + real tDCS) or control group (CoRE + sham tDCS). In each group, the intervention lasted 3 consecutive weeks (4 sessions/week). A neuropsychological assessment was administered at baseline (T0), post-intervention (T1) and 6-months later (T2).

Results: The CoRE + real tDCS group only improved in working memory and attention/processing speed at both T1 and T2. It reported a stable MMSE score at T2, while the CoRE + sham tDCS group worsened. Age, mood, and T0 MMSE score resulted to play a role in predicting treatment effects.

Conclusion: Combined multi-domain interventions may contribute to preventing or delaying disease progression.

Trial Registration: Trial registration number (ClinicalTrials.gov): NCT04118686.
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http://dx.doi.org/10.1007/s40520-021-01912-0DOI Listing
June 2021

The Smart Aging Platform for Assessing Early Phases of Cognitive Impairment in Patients With Neurodegenerative Diseases.

Front Psychol 2021 15;12:635410. Epub 2021 Mar 15.

National Neurological Institute C. Mondino Foundation, Pavia, Italy.

Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Smart Aging could differentiate between different types and levels of cognitive impairment in patients with neurodegenerative disease. Ninety-one subjects (mean age = 70.29 ± 7.70 years)-healthy older adults (HCs, = 23), patients with single-domain amnesic mild cognitive impairment (aMCI, = 23), patients with single-domain executive Parkinson's disease MCI (PD-MCI, = 20), and patients with mild Alzheimer's disease (mild AD, = 25)-were enrolled in the study. All participants underwent cognitive evaluations performed using both traditional neuropsychological assessment tools, including the Mini-Mental State Examination (MMSE), Montreal Overall Cognitive Assessment (MoCA), and the Smart Aging platform. We analyzed global scores on Smart Aging indices (i.e., accuracy, time, distance) as well as the Smart Aging total score, looking for differences between the four groups. The findings revealed significant between-group differences in all the Smart Aging indices: accuracy ( < 0.001), time ( < 0.001), distance ( < 0.001), and total Smart Aging score ( < 0.001). The HCs outperformed the mild AD, aMCI, and PD-MCI patients in terms of accuracy, time, distance, and Smart Aging total score. In addition, the mild AD group was outperformed both by the HCs and by the aMCI and PD-MCI patients on accuracy and distance. No significant differences were found between aMCI and PD-MCI patients. Finally, the Smart Aging scores significantly correlated with the results of the neuropsychological assessments used. These findings, although preliminary due to the small sample size, suggest the validity of Smart Aging as a screening tool for the detection of cognitive impairment in patients with neurodegenerative diseases.
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http://dx.doi.org/10.3389/fpsyg.2021.635410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005545PMC
March 2021

Risk Perception in a Real-World Situation (COVID-19): How It Changes From 18 to 87 Years Old.

Front Psychol 2021 2;12:646558. Epub 2021 Mar 2.

Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Studies on age-related differences in risk perception in a real-world situation, such as the recent COVID-19 outbreak, showed that the risk perception of getting COVID-19 tends to decrease as age increases. This finding raised the question on what factors could explain risk perception in older adults. The present study examined age-related differences in risk perception in the early stages of COVID-19 lockdown, analyzing variables that can explain the differences in perception of risk at different ages. A total of 1,765 adults aged between 18 and 87 years old completed an online survey assessing perceived risk severity and risk vulnerability of getting COVID-19, sociodemographic status, emotional state, experience relating to COVID-19, and physical health status. Results showed that the older the participants, the lower the perceived vulnerability to getting COVID-19, but the higher the perceived severity. Different predictors explain the perception of risk severity and vulnerability at different ages. Overall, self-reported anxiety over the pandemic is a crucial predictor in explaining risk perceptions in all age groups. Theoretical and practical implications of the empirical findings are discussed.
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http://dx.doi.org/10.3389/fpsyg.2021.646558DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961080PMC
March 2021

Can theory of mind of healthy older adults living in a nursing home be improved? A randomized controlled trial.

Aging Clin Exp Res 2021 Mar 8. Epub 2021 Mar 8.

Department of Brain and Behavioral Sciences, University of Pavia, Pizza Botta 6, 27100, Pavia, Italy.

Background: Research in nursing homes mainly focused on interventions for residents affected by cognitive decline. Few studies have considered healthy older adults living in nursing homes, and this research targeted cognitive functioning.

Aims: To evaluate whether socio-cognitive abilities can be improved by means of a theory of mind (ToM) training conducted by nursing home's operators.

Methods: RESULTS: Results revealed that older adults benefitted from the ToM intervention in both practiced and non-practiced tasks, while the control group showed no change from pre- to post-test evaluation. Analyses on errors scores indicated that the ToM intervention led to a reduction of both excessive mentalizing and absence of mental states inference.

Discussion: The conversation-based ToM intervention proved to be effective in improving socio-cognitive skills in cognitively healthy nursing home residents. Notably, older adults were able to transfer the skills acquired during the training to new material.

Conclusions: Promoting healthy resident's ToM ability could positively impact on their social cognition, consequently increasing their quality of life. Our findings showed that the intervention can be feasibly managed by health care assistants within the residential context.
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http://dx.doi.org/10.1007/s40520-021-01811-4DOI Listing
March 2021

The Early Impact of the Covid-19 Emergency on Mental Health Workers: A Survey in Lombardy, Italy.

Int J Environ Res Public Health 2020 11 20;17(22). Epub 2020 Nov 20.

Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l'Est-de-l'Île-de-Montréal, 7401 Rue Hochelaga, Montreal, QC H1N 3M5, Canada.

Lombardy was the epicenter of the Covid-19 outbreak in Italy, and in March 2020 the rapid escalation in cases prompted the Italian Government to decree a mandatory lockdown and to introduce safety practices in mental health services. The general objective of the study is to evaluate the early impact of the Covid-19 emergency and quarantine on the well-being and work practices of mental health service personnel and professionals. Data were collected through an online survey of workers and professionals working with people with mental health problems in Lombardy in several outpatient and inpatient services. Their socio-demographic characteristics, professional background, description of working conditions during lockdown and psychological distress levels were collected. All analyses were performed on a sample of 241. Approximately, 31% of the participants obtained a severe score in at least one of the burnout dimensions, 11.6% showed moderate or severe levels of anxiety, and 6.6% had a moderate or severe level of depression. Different work conditions and patterns of distress were found for outpatient service workers and inpatient service workers. The overall impact of the Covid-19 emergency on mental health workers' level of distress was mild, although a significant number of workers experienced severe levels of depersonalization and anxiety. More research is needed to assess specific predictive factors.
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http://dx.doi.org/10.3390/ijerph17228615DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699473PMC
November 2020

How to improve social communication in aging: Pragmatic and cognitive interventions.

Brain Lang 2020 12 1;211:104864. Epub 2020 Nov 1.

Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy.

Among all aspects of the linguistic and communicative competence, pragmatics seems especially vulnerable in aging, due also to cognitive decline. However, pragmatics has never been considered as an intervention target in healthy aging. Here we tested the effects of a novel training program to improve pragmatics (PragmaCom) in older adults, compared with an active cognitive control group in a randomized-controlled-trial design. Both the PragmaCom group and the control group improved in pragmatic skills such as understanding metaphors and avoiding off-topic speech, indicating that it is possible to improve pragmatics in aging both with a specific training and with a cognitive training. Individual cognitive factors predicted pragmatic improvement in the control group, while in the PragmaCom group benefits were less dependent on individual characteristics. We discuss the results in terms of pragmatic plasticity, highlighting the importance of these findings for promoting older adults' social communication and well-being.
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http://dx.doi.org/10.1016/j.bandl.2020.104864DOI Listing
December 2020

The Impact of Failures and Successes on Affect and Self-Esteem in Young and Older Adults.

Front Psychol 2019 6;10:1795. Epub 2019 Aug 6.

Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Older adults are assumed to change their affect states in reaction to positive and negative stimuli across the life span. However, little is known about the impact of success and failure events on age-related changes in affect states and, particularly, in self-esteem levels. To fill this gap in the literature, in the present study changes in affect and self-esteem in 100 young (19-30 years) and 102 older adults (65-81 years) were assessed after participants experienced success and failure in a demanding cognitive task. Overall, the success-failure manipulation induced changes on affect states and on state self-esteem, not on trait self-esteem. Regarding age differences, older and young adults were affected to the same extent by experiences of successes and failures. Theoretical considerations of the empirical findings are provided in the general discussion.
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http://dx.doi.org/10.3389/fpsyg.2019.01795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691139PMC
August 2019

Motivation and social-cognitive abilities in older adults: Convergent evidence from self-report measures and cardiovascular reactivity.

PLoS One 2019 10;14(7):e0218785. Epub 2019 Jul 10.

Department of Psychology, University of Otago, Dunedin, New Zealand.

Recently, some authors have suggested that age-related impairments in social-cognitive abilities-emotion recognition (ER) and theory of mind (ToM)-may be explained in terms of reduced motivation and effort mobilization in older adults. We examined performance on ER and ToM tasks, as well as corresponding control tasks, experimentally manipulating self-involvement. Sixty-one older adults and 57 young adults were randomly assigned to either a High or Low self-involvement condition. In the first condition, self-involvement was raised by telling participants were told that good task performance was associated with a number of positive, personally relevant social outcomes. Motivation was measured with both subjective (self-report questionnaire) and objective (systolic blood pressure reactivity-SBP-R) indices. Results showed that the self-involvement manipulation did not increase self-reported motivation, SBP-R, or task performance. Further correlation analyses focusing on individual differences in motivation did not reveal any association with performance, in either young or older adults. Notably, we found age-related decline in both ER and ToM, despite older adults having higher motivation than young adults. Overall, the present results were not consistent with previous claims that motivation affects older adults' social-cognitive performance, opening the route to potential alternative explanations.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218785PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619662PMC
February 2020

Prosocial behavior in aging: which factors can explain age-related differences in social-economic decision making?

Int Psychogeriatr 2019 12 20;31(12):1747-1757. Epub 2019 Feb 20.

Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Objectives: Older adults tend to exhibit more prosocial behavior than younger adults. However, little research has focused on understanding the factors that may explain such differences in the social decision-making process. The first aim was to examine if, and to what degree, the content of social information about a recipient has an impact on young vs. older adults' prosocial behavior. The second aim was to understand if empathic concern, Theory of Mind, and reasoning explain the (expected) age differences in prosociality.

Design: Cross-sectional study.

Setting: The study was conducted in northern Italy in a laboratory setting.

Participants: Forty-eight younger adults (Mage = 23.29; SD = 2.20) and 48 older adults (Mage = 70.19; SD = 5.13).

Measurements: Prosocial behavior was measured using the Dictator Game in which participants split a sum of money with recipients presented with four levels of description: no information, physical description, positive psychological description, and negative psychological description. In addition, participants performed tasks on emphatic concern, Theory of Mind, and reasoning.

Results: Results showed that older adults are more prosocial than younger adults in the Dictator Game. This finding was evident when the recipient was described with positive psychological and physical features. This pattern of results was statistically explained by the reduction in reasoning ability.

Conclusion: These findings suggest a relationship between age-related reduction in reasoning ability and older adults' prosocial behavior. The theoretical and practical implication of the empirical findings are discussed.
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http://dx.doi.org/10.1017/S1041610219000061DOI Listing
December 2019

Theory of mind, mental state talk and social relationships in aging: The case of friendship.

Aging Ment Health 2019 09 27;23(9):1105-1112. Epub 2018 Nov 27.

a Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.

Previous research has shown a decline in Theory of mind (ToM) associated with normal aging. However, very few studies have investigated older people's ToM using an ecological approach. The present study was designed to fill this gap and examine older people's frequency of mental state talk (MST) in describing their best friend, together with their performance on a traditional ToM task. In addition, the study examined the association between these two ToM indices and relationships with friends and family members. Seventy-two healthy older adults (age range 60-79) participated in the study. We measured ToM ability with a classic measure, the Faux Pas task, and selected the Describe-a-friend task to measure MST frequency; social relationships were investigated with the Lubben Social Network Scale. Correlation and regression analyses were performed. No significant association between MST and scores on the Faux Pas task emerged. In addition, MST (but not Faux Pas scores) significantly predicted friendships (but not family relationships) over and above general cognitive functioning. These findings show the crucial distinction between possessing an ability and using it in daily life and suggest the need to move toward more ecological measures of older adults' abilities. In addition, the present results indicate that the spontaneous use of ToM ability, not the ability per se, impacts on older adults' social relationships.
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http://dx.doi.org/10.1080/13607863.2018.1479832DOI Listing
September 2019

Investigating ToM in aging with the MASC: from accuracy to error type.

Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2019 07 24;26(4):541-557. Epub 2018 Jul 24.

a Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.

Growing evidence indicates that Theory of Mind (ToM) declines in normal aging. However, the majority of this research has used classic and static verbal tasks that present scenarios, which are very different from real life. The present study was designed to fill this gap by administering the Movie for the Assessment of Social Cognition (MASC) to young and older participants. It allows one to analyze not only the accuracy, but also the typology of error in mental states attribution distinguishing between iper-ToM (over-mentalization), ipo-ToM (insufficient mentalization), and no-ToM (lack of mentalization). We recruited 30 young (20-29 years), 39 young-old (65-74 years), and 31 old-old (75-86 years) participants. Along with the MASC, we administered a classic ToM task, the Strange Stories, and several measures of cognitive functioning. Results showed that older adults were less accurate in mental state attribution than young adults in the MASC, but not in the Strange Stories. In addition, compared to young adults, older adults committed more errors of both ipo- and no-ToM, while young adults committed more often iper-ToM errors. Additionally, older adults, but not young adults, did not show a difference between iper-ToM and ipo-ToM errors, which were equally frequent in this age group. Globally, results indicated that older adults' failure in classic ToM tasks may be due to both ipo- and iper-ToM and provide needed evidence for the MASC as a suitable measure of ToM in aging.
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http://dx.doi.org/10.1080/13825585.2018.1500996DOI Listing
July 2019

Decision-making competence in younger and older adults: which cognitive abilities contribute to the application of decision rules?

Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2019 03 28;26(2):174-189. Epub 2017 Dec 28.

a Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.

Older adults perform worse than younger adults when applying decision rules to choose between options that vary along multiple attributes. Although previous studies have shown that general fluid cognitive abilities contribute to the accurate application of decision rules, relatively little is known about which specific cognitive abilities play the most important role. We examined the independent roles of working memory, verbal fluency, semantic knowledge, and components of executive functioning. We found that age-related decline in applying decision rules was statistically mediated by age-related decline in working memory and verbal fluency. Our results have implications for theories of aging and decision-making.
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http://dx.doi.org/10.1080/13825585.2017.1418283DOI Listing
March 2019

The effect of strategic memory training in older adults: who benefits most?

Int Psychogeriatr 2018 08 7;30(8):1235-1242. Epub 2017 Dec 7.

Department of Brain and Behavioral Sciences,University of Pavia,Pavia,Italy.

ABSTRACTBackground:Previous research has suggested that there is a degree of variability among older adults' response to memory training, such that some individuals benefit more than others. The aim of the present study was to identify the profile of older adults who were likely to benefit most from a strategic memory training program that has previously proved to be effective in improving memory in healthy older adults.

Method: In total, 44 older adults (60-83 years) participated in a strategic memory training. We examined memory training benefits by measuring changes in memory practiced (word list learning) and non-practiced tasks (grocery list and associative learning). In addition, a battery of cognitive measures was administered in order to assess crystallized and fluid abilities, short-term memory, working memory, and processing speed.

Results: Results confirmed the efficacy of the training in improving performance in both practiced and non-practiced memory tasks. For the practiced memory tasks, results showed that memory baseline performance and crystallized ability predicted training gains. For the non-practiced memory tasks, analyses showed that memory baseline performance was a significant predictor of gain in the grocery list learning task. For the associative learning task, the significant predictors were memory baseline performance, processing speed, and marginally the age.

Conclusions: Our results indicate that older adults with a higher baseline memory capacity and with more efficient cognitive resources were those who tended to benefit most from the training. The present study provides new avenues in designing personalized intervention according to the older adults' cognitive profile.
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http://dx.doi.org/10.1017/S1041610217002691DOI Listing
August 2018

Smart Aging Platform for Evaluating Cognitive Functions in Aging: A Comparison with the MoCA in a Normal Population.

Front Aging Neurosci 2017 21;9:379. Epub 2017 Nov 21.

Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.

Smart Aging is a Serious games (SGs) platform in a 3D virtual environment in which users perform a set of screening tests that address various cognitive skills. The tests are structured as 5 tasks of activities of daily life in a familiar environment. The main goal of the present study is to compare a cognitive evaluation made with Smart Aging with those of a classic standardized screening test, the Montreal Cognitive Assessment (MoCA). One thousand one-hundred thirty-one healthy adults aged between 50 and 80 ( = 64.3 ± 8.3) were enrolled in the study. They received a cognitive evaluation with the MoCA and the Smart Aging platform. Participants were grouped according to their MoCA global and specific cognitive domain (i.e., memory, executive functions, working memory, visual spatial elaboration, language, and orientation) scores and we explored differences among these groups in the Smart Aging indices. One thousand eighty-six older adults ( = 64.0 ± 8.0) successfully completed the study and were stratified according to their MoCA score: Group 1 with MoCA < 27 ( = 360); Group 2 with 27 ≥ MoCA < 29 ( = 453); and Group 3 with MoCA ≥ 29 ( = 273). MoCA groups significantly differed in most of the Smart Aging indices considered, in particular as concerns accuracy (s < 0.001) and time (s < 0.001) for completing most of the platform tasks. Group 1 was outperformed by the other two Groups and was slower than them in these tasks, which were those supposed to assess memory and executive functions. In addition, significant differences across groups also emerged when considering the single cognitive domains of the MoCA and the corresponding performances in each Smart Aging task. In particular, this platform seems to be a good proxy for assessing memory, executive functions, working memory, and visual spatial processes. These findings demonstrate the validity of Smart Aging for assessing cognitive functions in normal aging. Future studies will validate this platform also in the clinical aging populations.
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http://dx.doi.org/10.3389/fnagi.2017.00379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702318PMC
November 2017

Plasticity in older adults' theory of mind performance: the impact of motivation.

Aging Ment Health 2018 12 8;22(12):1592-1599. Epub 2017 Sep 8.

c Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China.

Objective: Recently, motivation has been found to attenuate the age-related decline in Theory of Mind (ToM) performance (i.e. faux pas recognition). However, whether or not this effect could be generalized to other ToM tasks is still unknown. In the present study, we investigated whether and how motivation could enhance older adults' performance and reduce age differences in ToM tasks (Faux Pas vs. Animation task) that differ in familiarity.

Method: Following a previous paradigm, 171 Chinese adults (87 younger adults and 84 older adults) were recruited, and we experimentally manipulated the level of perceived closeness between participants and the experimenter before administering the ToM tasks in order to enhance participants' motivation.

Results: Results showed that, for the Faux Pas task, we replicated previous findings such that older adults under the enhanced motivation conditions performed equally well as younger adults. Conversely, for the Animation task, younger adults outperformed older adults, regardless of motivation.

Discussion: These results indicate that motivation can enhance older adults' performance in ToM tasks, however, this beneficial effect cannot be generalized across ToM tasks.
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http://dx.doi.org/10.1080/13607863.2017.1376313DOI Listing
December 2018

Self-guided strategy-adaption training for older adults: Transfer effects to everyday tasks.

Arch Gerontol Geriatr 2017 Sep 7;72:91-98. Epub 2017 Jun 7.

Georgia Institute of Technology, Atlanta, USA.

Objectives: The goal of the present research was to examine the potential of a learner-oriented approach to improving older adults' performance in tasks that are similar to real-life situations that require strategic deployment of cognitive resources. A crucial element of this approach involves encouraging older adults to explicitly analyze tasks to consider how to adapt trained skills to a new task context. In an earlier study, a specialist-directed intervention produced training gains and transfer to some untrained memory tasks.

Method: In the present study, older adults received a manual instructing them about principles of task analysis, two memory strategies, and strategy adaptation. Self-guided strategy-adaption training involved practicing some memory tasks as well as instructions on how the trained skills could be applied to new tasks that were not practiced. The criterion tasks involved practice tasks, non-practiced tasks that were discussed in the manual, and transfer tasks that were never mentioned in the manual. Two of the tests were from the Everyday Cognition Battery (inductive reasoning and working memory).

Results: As compared to a waiting-list control group, older adults assigned to self-guided strategy-adaption training showed memory improvements on tasks that were practiced or discussed during training. Most important, the learner-oriented approach produced transfer to the everyday tasks.

Conclusion: Our findings show the potential of instructing task appraisal processes as a basis for fostering transfer, including improving older adults' performance in simulated everyday tasks.
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http://dx.doi.org/10.1016/j.archger.2017.05.015DOI Listing
September 2017

Theory of mind plasticity in aging: The role of baseline, verbal knowledge, and executive functions.

Neuropsychol Rehabil 2019 Apr 7;29(3):440-455. Epub 2017 Apr 7.

a Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.

Theory of Mind (ToM) refers to the ability to attribute mental states to the self and others in order to explain and predict social behaviour. Meta-analytic results have shown a decline in ToM abilities in healthy older adults. Recent research has also highlighted the possibility of enhancing older adults' ToM performance through group conversations focused on mental states. Our aim was to determine whether the extent to which older people benefited from a ToM training was predicted by performance on a battery of executive functioning tasks, on baselines in ToM tasks, on verbal knowledge. Forty-three older adults (60-84 years) participated in a three-session ToM training programme that has previously shown to be effective in improving ToM ability. Results showed that verbal knowledge predicted training gains in practiced ToM tasks. In addition, age, executive functions and baseline performance predicted training gains in non-practiced ToM tasks. Results are discussed in light of the amplification model.
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http://dx.doi.org/10.1080/09602011.2017.1308871DOI Listing
April 2019

Updating working memory: memory load matters with aging.

Aging Clin Exp Res 2017 Jun 6;29(3):371-377. Epub 2016 May 6.

Brain and Behavioral Science Department, University of Pavia, Piazza Botta 11, 27100, Pavia, Italy.

Age-related effects in working memory updating were investigated by administering a response time-based task to three adult age groups (young, young-old, and old-old). The task differentiated objects to update; participants were asked to update single memory contents or content-context bindings. The data showed an overall delay of response latencies in the elderly groups (both young-old and old-old), relative to the younger. Specifically, each age group showed longer latencies for content-context binding updating, than single memory content updating. However, an interaction with age was obtained when memory load was manipulated across content-context binding updating conditions. These results were taken as evidence of differences between specific objects of updating and age-related changes in cognition and were discussed with reference to the relevant aging literature.
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http://dx.doi.org/10.1007/s40520-016-0581-yDOI Listing
June 2017

Theory of Mind and social relationships in older adults: the role of social motivation.

Aging Ment Health 2017 03 19;21(3):253-258. Epub 2015 Nov 19.

a Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.

Objectives: Previous research has shown that individual differences in Theory of Mind (ToM) are crucial for people's social relationships. However, very few studies have investigated this issue in ageing. The present study was designed to fill this gap and examine the associations between ToM and social relationships in elderly adults. In doing so, this study considered people's relationships with their relatives and friends, and examined the possible moderating role of social motivation.

Method: The study involved 53 healthy older adults (age: M = 67.91; SD = 6.93; range: 60--85 years). All participants were tested collectively during a 2-hr session and completed a demographic questionnaire as well as a battery of tests assessing verbal ability (vocabulary and word fluency), ToM and social relationships. They also answered a social motivation question.

Results: Results showed that individual differences in older people's ToM were overall significantly associated with those in relationships with friends, but not relatives. In addition, the Hayes moderating procedure showed that individual differences in ToM were related to those in friendships only for those people who had a high or medium level of social motivation.

Conclusion: These findings underline the importance of motivation in guiding the use of ToM in everyday social interactions.
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http://dx.doi.org/10.1080/13607863.2015.1114586DOI Listing
March 2017

Theory of Mind in aging: Comparing cognitive and affective components in the faux pas test.

Arch Gerontol Geriatr 2016 Jan-Feb;62:152-62. Epub 2015 Sep 26.

Department of Brain and Behavioral Sciences, University of Pavia, Italy.

Objectives: Theory of Mind (ToM) is a complex human ability that allows people to make inferences on others' mental states such as beliefs, emotions and desires. Previous studies on ToM in normal aging have provided heterogeneous findings. In the present study we examined whether a mixed calculation of different aspects of ToM may have contributed to these conflicting results. We had two aims. First, we explored the age-related changes in the performance of cognitive vs. affective ToM. Second, we investigated the extent to which the effect of aging on cognitive vs. affective ToM is mediated by age-related differences in executive functions.

Method: To address these issues three age groups (young, young-old, and old-old adults) were compared on cognitive and affective ToM using the faux pas test. In addition, participants were tested using a battery of executive function tasks tapping on inhibition, working memory updating, and word fluency.

Results: The analyses indicated that young adults outperform both young-old and old-old adults on cognitive ToM but not on affective ToM. Correlations showed that, whereas cognitive ToM was significantly associated with age, working memory updating, and inhibition, affective ToM was not. Finally, analyses revealed that individual differences in working memory updating (but not inhibition) mediated the effect of age on cognitive ToM.

Conclusion: Our findings support the view of selective age-related differences on cognitive, but not affective, ToM in normal aging. The distinction between the two ToM components is further supported by a dissociable pattern of correlations with executive functions.
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http://dx.doi.org/10.1016/j.archger.2015.09.009DOI Listing
April 2016

Training for generalization in Theory of Mind: a study with older adults.

Front Psychol 2015 4;6:1123. Epub 2015 Aug 4.

Department of Brain and Behavioral Sciences, University of Pavia , Pavia, Italy.

Theory of Mind (ToM) refers to the ability to attribute independent mental states to self and others in order to explain and predict social behavior. Recent research in this area has shown a decline in ToM abilities associated with normal aging that is of a moderate magnitude or greater. Very few studies have investigated whether it is possible to improve older adults' ToM abilities. The present study was designed to address this gap in the literature by evaluating the impact of a ToM training on practiced and transfer tasks. We provided older adults with a variety of activities designed to facilitate the generalization of benefits to other ToM-demanding tasks. Participants were 63 healthy older adults, native Italian speakers (M age = 71.44, SD = 5.24, age range: 63-81 years). Participants were randomly assigned to one of two groups: the ToM training (age range: 63-81 years) and the physical-conversation training (age range: 64-81 years). Training effects were measured using the strange stories (practiced task) and the animation task (transfer task). Results revealed the efficacy of the training in producing improvements on practiced but also on transfer tasks.
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http://dx.doi.org/10.3389/fpsyg.2015.01123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4523701PMC
August 2015

Promoting theory of mind in older adults: does age play a role?

Aging Ment Health 2016 1;20(1):22-8. Epub 2015 Jun 1.

a Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.

Objectives: Previous research on age-related changes in Theory of Mind (ToM) showed a decline in older adults, particularly pronounced over 75 years of age. Evidence that ToM may be enhanced in healthy aging people has been demonstrated, but no study has focused on the role of age on the effects of ToM training for elderly people. The present study was designed to examine the efficacy of a ToM training on practiced (ToM Strange Stories) and transfer tasks (ToM Animations) in both young and older adults.

Method: The study involved 127 older adults belonging to two age groups: young-old (Mage = 64.41; SD = 2.49; range: 60-69 years) and old-old (Mage = 75.66; SD = 4.38; range: 70-85 years), randomly assigned to either a ToM group or a control group condition. All participants took part in two 2-hour testing sessions and four 2-hour training sessions.

Results: Results showed that both young-old and old-old adults in the ToM group condition improved their ability to reason on complex-mental states significantly more than participants in the control group condition. This positive effect of the training was evident on practiced and transfer ToM tasks. Crucially, age did not moderate the effect of the ToM training.

Conclusion: These findings demonstrate that young-old and old-old adults equally benefit from the ToM training. Implications for the positive effect of the ToM training in old-old adults are discussed.
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http://dx.doi.org/10.1080/13607863.2015.1049118DOI Listing
May 2016

Serious games for screening pre-dementia conditions: from virtuality to reality? A pilot project.

Funct Neurol 2014 Jul-Sep;29(3):153-8

Conventional cognitive assessment is based on a pencil-and-paper neuropsychological evaluation, which is time consuming, expensive and requires the involvement of several professionals. Information and communication technology could be exploited to allow the development of tools that are easy to use, reduce the amount of data processing, and provide controllable test conditions. Serious games (SGs) have the potential to be new and effective tools in the management and treatment of cognitive impairments Serious games for screening pre-dementia conditions: from virtuality to reality? A pilot project in the elderly. Moreover, by adopting SGs in 3D virtual reality settings, cognitive functions might be evaluated using tasks that simulate daily activities, increasing the "ecological validity" of the assessment. In this commentary we report our experience in the creation of the Smart Aging platform, a 3D SGand virtual environment-based platform for the early identification and characterization of mild cognitive impairment.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264781PMC
July 2015

Training older adults on Theory of Mind (ToM): transfer on metamemory.

Arch Gerontol Geriatr 2015 Jan-Feb;60(1):217-26. Epub 2014 Oct 14.

Department of Brain and Behavioral Sciences, University of Pavia, Italy. Electronic address:

Background: Research on aging has shown a significant decline in ToM after 65 years of age. Despite these age-related difficulties, no study has yet investigated the possibility to improve ToM in older adults. To address this gap we tested the efficacy of a conversation-based ToM training with age-appropriate ToM tasks and its transfer effects on metamemory.

Method: We examined 72 older adults (Mage=67.61 years, SD=6.39 years) assigned to three training conditions: a ToM training, a physical-conversation training and a social-contact group. All participants took part in two 2-h testing and to two 2-h training sessions.

Results: Results showed that after the intervention, older adults in the ToM training group improved their mental states' understanding significantly more than participants in the physical-conversation training and in the social-contact groups. Crucially, the positive effect of the ToM intervention generalized to metamemory knowledge.

Conclusions: This is the first study investigating the efficacy of a ToM training and its transfer effect on metacognition in older adults. From a theoretical point of view, it supports the relation between ToM and metamemory. Practical implications of these data are discussed.
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http://dx.doi.org/10.1016/j.archger.2014.10.001DOI Listing
August 2015

Self-help memory training for healthy older adults in a residential care center: specific and transfer effects on performance and beliefs.

Int J Geriatr Psychiatry 2015 Aug 11;30(8):870-80. Epub 2014 Nov 11.

Department of General Psychology, University of Padua, Padua, Italy.

Background: Cognitive flexibility has repeatedly been shown to improve after training programs in community-dwelling older adults, but few studies have focused on healthy older adults living in other settings.

Objectives: This study investigated the efficacy of self-help training for healthy older adults in a residential care center on memory tasks they practiced (associative and object list learning tasks) and any transfer to other tasks (grocery lists, face-name learning, figure-word pairing, word lists, and text learning). Transfer effects on everyday life (using a problem-solving task) and on participants' beliefs regarding their memory (efficacy and control) were also examined. With the aid of a manual, the training adopted a learner-oriented approach that directly encouraged learners to generalize strategic behavior to new tasks. The maintenance of any training benefits was assessed after 6 months.

Method: The study involved 34 residential care center residents (aged 70-99 years old) with no cognitive impairments who were randomly assigned to two programs: the experimental group followed the self-help training program, whereas the active control group was involved in general cognitive stimulation activities.

Results: Training benefits emerged in the trained group for the tasks that were practiced. Transfer effects were found in memory and everyday problem-solving tasks and on memory beliefs. The effects of training were generally maintained in both practiced and unpracticed memory tasks.

Conclusion: These results demonstrate that learner-oriented self-help training enhances memory performance and memory beliefs, in the short term at least, even in residential care center residents.
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http://dx.doi.org/10.1002/gps.4230DOI Listing
August 2015

The cognitive effects of listening to background music on older adults: processing speed improves with upbeat music, while memory seems to benefit from both upbeat and downbeat music.

Front Aging Neurosci 2014 15;6:284. Epub 2014 Oct 15.

Brain and Behavioral Sciences Department, University of Pavia Pavia, Italy.

Background music refers to any music played while the listener is performing another activity. Most studies on this effect have been conducted on young adults, while little attention has been paid to the presence of this effect in older adults. Hence, this study aimed to address this imbalance by assessing the impact of different types of background music on cognitive tasks tapping declarative memory and processing speed in older adults. Overall, background music tended to improve performance over no music and white noise, but not always in the same manner. The theoretical and practical implications of the empirical findings are discussed.
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http://dx.doi.org/10.3389/fnagi.2014.00284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197792PMC
October 2014

Training preschoolers on first-order false belief understanding: transfer on advanced ToM skills and metamemory.

Child Dev 2014 Nov-Dec;85(6):2404-18. Epub 2014 Jul 14.

University of Pavia.

This study investigated the relation between theory of mind (ToM) and metamemory knowledge using a training methodology. Sixty-two 4- to 5-year-old children were recruited and randomly assigned to one of two training conditions: A first-order false belief (ToM) and a control condition. Intervention and control groups were equivalent at pretest for age, parents' education, verbal ability, inhibition, and ToM. Results showed that after the intervention children in the ToM group improved in their first-order false belief understanding significantly more than children in the control condition. Crucially, the positive effect of the ToM intervention was stable over 2 months and generalized to more complex ToM tasks and metamemory.
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http://dx.doi.org/10.1111/cdev.12267DOI Listing
August 2015

The importance of training strategy adaptation: a learner-oriented approach for improving older adults' memory and transfer.

J Exp Psychol Appl 2013 Sep 26;19(3):205-18. Epub 2013 Aug 26.

Brain Connectivity Center, National Neurological Institute C. Mondino.

We investigated the benefits of strategy-adaptation training for promoting transfer effects. This learner-oriented approach--which directly encourages the learner to generalize strategic behavior to new tasks--helps older adults appraise new tasks and adapt trained strategies to them. In Experiment 1, older adults in a strategy-adaptation training group used 2 strategies (imagery and sentence generation) while practicing 2 tasks (list and associative learning); they were then instructed on how to do a simple task analysis to help them adapt the trained strategies for 2 different unpracticed tasks (place learning and text learning) that were discussed during training. Two additional criterion tasks (name-face associative learning and grocery-list learning) were never mentioned during training. Two other groups were included: A strategy training group (who received strategy training and transfer instructions but not strategy-adaptation training) and a waiting-list control group. Both training procedures enhanced older adults' performance on the trained tasks and those tasks that were discussed during training, but transfer was greatest after strategy-adaptation training. Experiment 2 found that strategy-adaptation training conducted via a manual that older adults used at home also promoted transfer. These findings demonstrate the importance of adopting a learner-oriented approach to promote transfer of strategy training.
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http://dx.doi.org/10.1037/a0034078DOI Listing
September 2013

Beyond false belief: theory of mind in young, young-old, and old-old adults.

Int J Aging Hum Dev 2013 ;76(3):181-98

University of Pavia, Italy.

Theory of mind (ToM) refers to humans' ability to recognize the existence of mental states, such as beliefs, emotions, and desires. The literature on ToM in aging and on the relationship between ToM and other cognitive functions, like executive functions, is not homogenous. The aim of the present study was to explore the course of ToM and to investigate the role of working memory, inhibition, and language on the possible age differences in ToM. To address these issues, we examined ToM using the Strange Stories task and executive function task in three age groups. Results showed that young adults outperform both old groups on the ToM stories. This difference remains significant also when controlling for working memory and inhibitory control. Our findings suggest a specific impairment in inferring mental states starting from 60 years of age that seems to be independent of changes in executive functions.
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http://dx.doi.org/10.2190/AG.76.3.aDOI Listing
July 2013
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