Background: Frailty is considered highly prevalent in old age and to confer high risk for falls, disability, hospitalization, and mortality. Frailty has been considered synonymous with disability, comorbidity, and other characteristics, but it is recognized that it may have a biologic basis and be a distinct clinical syndrome. A standardized definition has not yet been established. 

Methods: To develop and operationalize a phenotype of frailty in older adults and assess concurrent and predictive validity, the study used data from the Cardiovascular Health Study. Participants were 5,317 men and women 65 years and older (4,735 from an original cohort recruited in 1989-90 and 582 from an African American cohort recruited in 1992-93). Both cohorts received almost identical baseline evaluations and 7 and 4 years of follow-up, respectively, with annual examinations and surveillance for outcomes including incident disease, hospitalization, falls, disability, and mortality. 

Results: Frailty was defined as a clinical syndrome in which three or more of the following criteria were present: unintentional weight loss (10 lbs in past year), self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity. The overall prevalence of frailty in this community-dwelling population was 6.9%; it increased with age and was greater in women than men. Four-year incidence was 7.2%. Frailty was associated with being African American, having lower education and income, poorer health, and having higher rates of comorbid chronic diseases and disability. There was overlap, but not concordance, in the cooccurrence of frailty, comorbidity, and disability. This frailty phenotype was independently predictive (over 3 years) of incident falls, worsening mobility or ADL disability, hospitalization, and death, with hazard ratios ranging from 1.82 to 4.46, unadjusted, and 1.29-2.24, adjusted for a number of health, disease, and social characteristics predictive of 5-year mortality. Intermediate frailty status, as indicated by the presence of one or two criteria, showed intermediate risk of these outcomes as well as increased risk of becoming frail over 3-4 years of follow-up (odds ratios for incident frailty = 4.51 unadjusted and 2.63 adjusted for covariates, compared to those with no frailty criteria at baseline). 

Conclusions: This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition. It also finds that there is an intermediate stage identifying those at high risk of frailty. Finally, it provides evidence that frailty is not synonymous with either comorbidity or disability, but comorbidity is an etiologic risk factor for, and disability is an outcome of, frailty. This provides a potential basis for clinical assessment for those who are frail or at risk, and for future research to develop interventions for frailty based on a standardized ascertainment of frailty.

https://www.sharp.com/services/hospice/upload/phenotype5-13.pdf

Frailty in Older Adults Evidence for a Phenotype

Despite the concern that has been expressed about potential method biases, and the pervasiveness of research settings with the potential to produce them, there is disagreement about whether they really are a problem for researchers in the behavioral sciences. Therefore, the purpose of this review is to explore the current state of knowledge about method biases. First, we explore the meaning of the terms “method” and “method bias” and then we examine whether method biases influence all measures equally. Next, we review the evidence of the effects that method biases have on individual measures and on the covariation between different constructs. Following this, we evaluate the procedural and statistical remedies that have been used to control method biases and provide recommendations for minimizing method bias.

Sources of Method Bias in Social Science Research and Recommendations on How to Control It

because observed behavior is the result of interactions between environmental factors and genes during the extended period of development. Therefore, to better understand expert and exceptional performance, we must require that the account specify the different environmental factors that could selectively promote and facilitate the achievement of such performance. In addition, recent research on expert performance and expertise (Chi, Glaser, & Farr, 1988; Ericsson & Smith, 1991a) has shown that important characteristics of experts' superior performance are acquired through experience and that the effect of practice on performance is larger than earlier believed possible. For this reason, an account of exceptional performance must specify the environmental circumstances, such as the duration and structure of activities, and necessary minimal biological attributes that lead to the acquisition of such characteristics and a corresponding level of performance. An account that explains how a majority of individuals can attain a given level of expert performance might seem inherently unable to explain the exceptional performance of only a small number of individuals. However, if such an empirical account could be empirically supported, then the extreme characteristics of experts could be viewed as having been acquired through learning and adaptation, and studies of expert performance could provide unique insights into the possibilities and limits of change in cognitive capacities and bodily functions. In this article we propose a theoretical framework that explains expert performance in terms of acquired characteristics resulting from extended deliberate practice and that limits the role of innate (inherited) characteristics to general levels of activity and emotionality. We provide empirical support from two new studies and from already published evidence on expert performance in many different domains.

/pdf/the-role-of-deliberate-practice-in-the-acquisition-of-expert-3j9768t5su.pdf

The role of deliberate practice in the acquisition of expert performance.

Recent studies of eye movements in reading and other information processing tasks, such as music reading, typing, visual search, and scene perception, are reviewed. The major emphasis of the review is on reading as a specific example of cognitive processing. Basic topics discussed with respect to reading are (a) the characteristics of eye movements, (b) the perceptual span, (c) integration of information across saccades, (d) eye movement control, and (e) individual differences (including dyslexia). Similar topics are discussed with respect to the other tasks examined. The basic theme of the review is that eye movement data reflect moment-to-moment cognitive processes in the various tasks examined. Theoretical and practical considerations concerning the use of eye movement data are also discussed.

/pdf/eye-movements-in-reading-and-information-processing-20-years-3z5ay8hdwc.pdf

Eye movements in reading and information processing: 20 years of research.

A theory is proposed to account for some of the age-related differences reported in measures of Type A or fluid cognition. The central hypothesis in the theory is that increased age in adulthood is associated with a decrease in the speed with which many processing operations can be executed and that this reduction in speed leads to impairments in cognitive functioning because of what are termed the limited time mechanism and the simultaneity mechanism. That is, cognitive performance is degraded when processing is slow because relevant operations cannot be successfully executed (limited time) and because the products of early processing may no longer be available when later processing is complete (simultaneity). Several types of evidence, such as the discovery of considerable shared age-related variance across various measures of speed and large attenuation of the age-related influences on cognitive measures after statistical control of measures of speed, are consistent with this theory.

http://www.anitacrawley.net/Resources/Articles/salthouse%20The%20Processing%20Speed%20Theory%20of%20Adult%20Age%20Differences%20in%20Cognition.pdf

The processing-speed theory of adult age differences in cognition.

Anticipatory processing in transcription typing.

Data from three studies involving a continuous paired associates task performed by adults of different ages were analyzed, in an attempt to identify how processing speed might mediate age-related differences in associative memory. Age differences were found in measures postulated to represent encoding and consolidation processes, but not in a measure presumed to reflect rate offorgetting. It is suggested that increased age is associated with a reduction in the speed ofexecuting processes concerned with establishing a stable internal representation, but not with an alteration in the rate at which encoded information is lost as a function of time or subsequent pro

Selective influences of age and speed on associative memory.

Two research strategies were employed to investigate reasons for the poorer performance associated with increased age on perceptual closure tasks involving the integration and identification of incomplete pictures. One strategy consisted of examining age differences in measures designed to reflect the proficiency of processing components presumed to be involved in the closure task. The performance of older adults was significantly worse than that of young adults on each measure, suggesting that the age differences in the criterion task could not be localized in a single specific component. The second strategy involved determining whether young and old adults differed in the effects of practice or in the amount of specific and general transfer resulting from that practice. No age differences other than those in the overall level of performance were discovered, indicating that the age-associated problem may be independent of the processes contributing to the acquisition and transfer of new information. It was suggested that the age differences in perceptual closure tasks originate because of a general inefficiency in information processing due to a reduction in some type of general-purpose processing resource, and not because of a limitation in a single specific process.

https://www.jstor.org/stable/pdfplus/1422836.pdf

Effects of aging on perceptual closure.

There is frequent reference in the literature on aging and performance to the “slowing with age phenomenon.” If there truly is one “slowing with age” phenomenon, then all activities requiring speeded performance should decline with age at approximately the same rate. This report compares relative rates of age decline in several speeded physical activities ranging from simple reaction time to long-distance running events. The activities differ in the rate of slowing, with those requiring a greater muscular involvement or more stamina exhibiting the steepest declines. It is concluded that when one refers to slowing with age it is necessary to be quite specific about the activity to which one is referring because different activities decline at different rates.

Speed and age: multiple rates of age decline.

Methods. Cogniti ve scores were compared in different individuals from the same birth years who were tested in different years, when they were at different ages. These types of quasi-longitudinal comparisons were carried out on data from three large projects: the Seattle Longitudinal Study [Schaie, K. W. (2013). Developmental influences on adult intelligence: The Seattle Longitudinal Study (2nd ed.). New York, NY: Oxford University Press], the Betula Project [Ronnlund, M., & Nilsson, L-G. (2008). The magnitude, generality, and determinants of Flynn effects on forms of declarative memory and visuospatial ability: Time-sequential analyses of data from a Swedish cohort study. Intelligence, 36, 192–209], and the Virginia Cognitive Aging Project (this study). Results. In each data set, the results re vealed that the estimates of cognitive change with no prior test experience closely resembled the estimates of age relations based on cross-sectional comparisons. Furthermore, longitudinal comparisons revealed positive changes at young ages that gradually became more negative with increased age, whereas all of the estimates of change without prior test experience were negative except those for measures of vocabulary. Discussion. The current results suggest that retest ef fects can distort the mean age trends in longitudinal comparisons that are not adjusted for experience. Furthermore, the findings can be considered robust because the patterns were similar across three data sets involving different samples of participants and cognitive tests, and across different methods of controlling experience effects in the new data set.

/pdf/aging-cognition-unconfounded-by-prior-test-experience-4uascmbct9.pdf

Aging Cognition Unconfounded by Prior Test Experience

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