Graduate Thesis Or Dissertation

 

Adapting the Head-Toes-Knees-Shoulders Task to Older Adults : The Psychometric Evaluationand Theoretical Exploration of a Measure of Executive Function Public Deposited

Downloadable Content

Download PDF
https://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/s4655j71h

Descriptions

Attribute NameValues
Creator
Abstract
  • With an estimated 5.4 million Americans living with Alzheimer’s disease facing individual, social, and financial burdens, researchers must make cognitive assessment inquiries a priority (Alzheimer’s Association, 2016). Cognition encompasses multiple aspects of thought processes, such as multiple types of memory, planning, inhibitory control, attention, and processing speed. The higher level cognitive processes, collectively known as executive function (EF) abilities, are widely recognized as the components of cognition most likely to show age-related declines (Jurado & Rosselli, 2007). This thesis study features a new way of measuring EF in community dwelling older adults through the adaptation of a well-known measure of EF in children, the Head-Toes-Knees-Shoulders task (HTKS; McClelland & Cameron, 2012). The HTKS is a game-like task administered between participant and examiner designed to measure EF abilities of working memory, cognitive flexibility, and inhibitory control by assessing participant’s responses to a maximum of four paired behavioral rules: “touch your head” and “touch your toes;” “touch your shoulders” and “touch your knees.” Under life span developmental theory’s selection, optimization, and compensation model, (SOC; Baltes, 1997), the underlying goals of this thesis were to 1) determine the reliability and validity of the HTKS when administered in an older adult sample, and investigate the 2) personality characteristics and 3) strategy processes related to better performance on the task. First, we hypothesized good internal consistency, good convergent validity as compared to the NIH Toolbox: Cognition Battery (Gershon et al., 2013), and good discriminant validity as compared to the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988). Second, we hypothesized higher levels of neuroticism would be related to poorer HTKS performance, and higher levels of openness and agreeableness would be related to better HTKS performance. Third, we hypothesized older adults would use some form of strategy when completing the HTKS, and higher levels of SOC-related strategies as measured by an open-ended strategy question and the SOC questionnaire (Baltes, Baltes, Freund, & Lang, 1995) would be related to better performance on the HTKS. A sample of 150 community dwelling older adults (M = 68.55 years of age, SD = 6.34 years of age, 72% Female) was recruited to participate in a scheduled hour of cognitive testing. Among these participants, the HTKS total score had an unexpected ceiling effect, possibly due to the relatively healthy and highly educated characteristics of the sample. Due to the ceiling effect and little variation in HTKS total score, we utilized an additional variable named HTKS completion time that allowed for the study of an additional element of cognition, speed of processing. Completion time allowed for a measure of HTKS performance with more variability and provided a way to measure speed of processing via timed completion of the task. Good internal consistency for the HTKS was demonstrated by Cronbach’s alpha of the overall HTKS task (α = .84) and its inter-item α range (.82 – .84). Bivariate correlations between the HTKS variables (total score and completion time) and individual scores on the NIH Toolbox: Cognition Battery were used to assess convergent validity. Correlations between the HTKS and NIHTB measures were strongest for completion time (not total score) as the measure of HTKS performance. EF processing as measured by HTKS completion time was associated with better processing speed (r = -0.30), attention (r = -0.21), and inhibitory control (r = -0.20), but not working memory. When using HTKS total score, better EF functioning as measured by HTKS total score was associated with better processing speed (r = 0.24) and attention (r = 0.17), but not inhibitory control or working memory. Both HTKS completion time and total score were unrelated to positive and negative affect (all ps > .05). The consistency of this pattern of no-association between HTKS variables and affect is in support of our hypothesis and demonstrates good discriminant validity. Partial support for the personality hypothesis was found. After adjusting for demographic variables, emotional stability and conscientiousness related to better HTKS performance as measured by HTKS completion time, and higher levels of agreeableness were associated with lower HTKS total scores. As hypothesized, 84% of the sample reported using some kind of strategy while completing the HTKS (36% employed SOC-related strategies). After adjusting for demographics, there were no significant relationships between SOC use and HTKS. Contrary to the hypothesis, HTKS performance was not related to any subscale on the SOC questionnaire. This thesis study provides evidence for the HTKS as a reliable and valid measure of EF in a community dwelling older adult sample. We argue these findings pave the way for future studies to examine the HTKS as a potential new and effective MCI and dementia screening instrument. The HTKS is a brief, low-cost, easy to administer instrument that incorporates motoric engagement in ways that existing cognitive screening tools do not.
License
Resource Type
Date Issued
Degree Level
Degree Name
Degree Field
Degree Grantor
Commencement Year
Advisor
Committee Member
Academic Affiliation
Non-Academic Affiliation
Subject
Rights Statement
Publisher
Peer Reviewed
Language
Replaces
Additional Information
  • description.provenance : Approved for entry into archive by Julie Kurtz(julie.kurtz@oregonstate.edu) on 2016-12-19T21:46:55Z (GMT) No. of bitstreams: 1 CerinoEricS2017.pdf: 1264306 bytes, checksum: 264fa578e39d624e9556e46e59aa26cb (MD5)
  • description.provenance : Approved for entry into archive by Laura Wilson(laura.wilson@oregonstate.edu) on 2016-12-20T17:36:47Z (GMT) No. of bitstreams: 1 CerinoEricS2017.pdf: 1264306 bytes, checksum: 264fa578e39d624e9556e46e59aa26cb (MD5)
  • description.provenance : Submitted by Eric Cerino (cerinoe@oregonstate.edu) on 2016-12-18T16:25:30Z No. of bitstreams: 1 CerinoEricS2017.pdf: 1264306 bytes, checksum: 264fa578e39d624e9556e46e59aa26cb (MD5)
  • description.provenance : Made available in DSpace on 2016-12-20T17:36:47Z (GMT). No. of bitstreams: 1 CerinoEricS2017.pdf: 1264306 bytes, checksum: 264fa578e39d624e9556e46e59aa26cb (MD5) Previous issue date: 2016-12-07
Embargo date range
  • 2017-08-04 to 2018-02-27

Relationships

Parents:

This work has no parents.

In Collection:

Items