Brian J Ayotte

University of Massachusetts Dartmouth, New Bedford, Massachusetts, United States

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Publications (18)38.95 Total impact

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    ABSTRACT: Objective Previous investigations into the relationship between late-life depressive symptoms and cognitive functioning have resulted in mixed findings concerning whether or not depressive symptoms and cognitive functioning are related. The mixed reports may be due in part to differences in clinical and nonclinical samples and to inadequate consideration of the dynamic nature (i.e., fluctuating course) of depressive symptoms and cognitive functioning in older adults. The current study examined the chronic, acute, and longitudinal relationships between depressive symptoms and cognitive functioning in older adults in an ongoing treatment study of major depressive disorder (MDD).Methods The neurocognitive outcomes of depression in the elderly study operates in a naturalistic treatment milieu using a pharmacological treatment algorithm and regular psychiatric assessment. Four hundred and fifty-three older adults [mean age 70 years, standard deviation (SD) = 7.2] meeting criteria for MDD at study enrollment received annual neuropsychological testing and depressive symptom monitoring for an average of 8.5 years (SD = 4.5).ResultsHierarchical linear modeling revealed that higher age, lower education, and higher average/chronic levels of depressive symptoms were related to lower cognitive functioning. Additionally, results revealed that when an individual's depressive symptoms are higher than is typical for a specific individual, general cognitive function was worse than average. There was no evidence of lagged/longitudinal relationships between depressive symptoms and cognitive functioning in older adults in treatment for MDD.Conclusions Cognitive functioning and depressive symptoms are concurrently associated in older adults with MDD, highlighting the potential importance for stabilizing mood symptoms as a means to manage cognitive deficits in late-life depression. Copyright © 2015 John Wiley & Sons, Ltd.
    International Journal of Geriatric Psychiatry 02/2015; DOI:10.1002/gps.4264 · 3.09 Impact Factor
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    ABSTRACT: The purpose of this study was to examine the associations among self-efficacy, perceived support, and physical activity in middle-aged and older married couples. A total of 116 middle-aged and older couples (M = 58.86 years, SD = 7.16, range 50-74) participated in the study. A dyadic approach to path modeling was taken. The final model indicated that for both husbands and wives, one's own self-efficacy was directly related to physical activity. In addition, husband self-efficacy was positively related to wive physical activity and indirectly related to wife physical activity through wife self-efficacy. Wife self-efficacy was indirectly related to husband physical activity via the level of husband perceived support. These results provide evidence for the importance of incorporating spousal characteristics in addition to individual characteristics when investigating physical activity during middle and later married life. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychology and Aging 06/2013; 28(2):555-563. DOI:10.1037/a0032454 · 2.73 Impact Factor
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    ABSTRACT: ABSTRACT Social support and functional ability are related to a number of outcomes in later life among African Americans, including cognitive performance. This study examined how providing and receiving social support was related to fluid and crystallized cognitive abilities among aging African American adults after accounting for functional limitations, age, education, sex, income, and self-reported health. Data from 602 African American adults (M = 69.08, SD = 9.74; 25% male) were analyzed using latent variable modeling. Fluid ability was a second-order factor indicated by measures that assessed verbal memory, working memory, perceptual speed, and inductive reasoning. Crystallized ability was a first-order factor indicated by three measures that assessed vocabulary (Shipley Verbal Meaning Test and parts A and B of the ETS Vocabulary Test). Results indicated that the receipt of social support was negatively related to both fluid and crystallized abilities, while the provision of support was positively related to fluid and crystallized ability. Follow-up tests found that the receipt of support was more strongly related to fluid ability than crystallized ability. There was no significant difference regarding the relationship of provision of support with fluid ability compared to crystallized ability. Results discuss the importance of considering the social context of older adults when examining cognitive ability.
    Aging Neuropsychology and Cognition 03/2013; DOI:10.1080/13825585.2012.761669 · 1.07 Impact Factor
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    ABSTRACT: Background/Study Context: Everyday cognition represents the ability to solve problems within domains that are representative of issues faced by adults on a daily basis. The current study examined individual differences in everyday cognitive ability among aging Black/African American adults. Methods: Demographic data on age, gender, education, physical functioning, chronic illnesses, self-reported health, and depression were collected from 248 African American adults (mean age = 67.8 years, standard deviation = 8.47 years). A multiple indicators, multiple causes (MIMIC) modeling approach was used to examine the associations of individual characteristics with latent everyday cognitive ability and composite score indicators. Results: Age, depressive symptoms, and number of chronic illnesses were negatively related to latent everyday cognition. The individual characteristics of age, depressive symptoms, self-rated health, and education were directly associated with composite indicators of latent everyday cognition. This suggests that within this sample of older Black/African American adults that certain composite scores (i.e., telephone use, food preparation, and finances) may be particularly sensitive to these individual characteristics. Conclusion: These results identify specific sources of variability in everyday cognitive ability among aging Blacks/African Americans. These individual differences should be accounted for when studying everyday cognition among Blacks/African Americans and when comparing the everyday cognitive ability of Blacks/African Americans with other groups.
    Experimental Aging Research 10/2012; 38(5):488-510. DOI:10.1080/0361073X.2012.726022 · 1.10 Impact Factor
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    ABSTRACT: Chronic stressors such as perceived discrimination might underlie race disparities in cardiovascular disease. This study focused on the relationship between perceived discrimination and risk of severe coronary obstruction while also accounting for multiple psychosocial variables and clinical factors. Data from 793 (629 white and 164 black) male veterans with positive nuclear imaging studies were analyzed. Participants were categorized as being at low/moderate or high risk for severe coronary obstruction based on results of their nuclear imaging studies. Hierarchical logistic regression models were tested separately for blacks and whites. The first step of the models included clinical factors. The second step included the psychosocial variables of optimism, religiosity, negative affect, and social support. The final step included perceived discrimination. Perceived discrimination was positively related to risk of severe obstruction among blacks but not among whites after controlling for clinical and psychosocial variables. Similar results were found in patients who underwent coronary angiography (n = 311). Perceived discrimination was associated with risk of severe coronary obstruction among black male veterans and could be an important target for future interventions.
    American heart journal 04/2012; 163(4):677-83. DOI:10.1016/j.ahj.2012.01.006 · 4.56 Impact Factor
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    ABSTRACT: The current analysis examined (a) if measures of psychological well-being predict subjective memory, and (b) if subjective memory is consistent with actual memory. Five hundred seventy-nine older African Americans from the Baltimore Study of Black Aging completed measures assessing subjective memory, depressive symptomatology, perceived stress, locus of control, and verbal and working memory. Higher levels of perceived stress and greater externalized locus of control predicted poorer subjective memory, but subjective memory did not predict objective verbal or working memory. Results suggest that subjective memory is influenced by aspects of psychological well-being but is unrelated to objective memory in older African Americans.
    Experimental Aging Research 03/2011; 37(2):220-40. DOI:10.1080/0361073X.2011.555640 · 1.10 Impact Factor
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    ABSTRACT: To determine subtypes of adherence, 636 hypertensive patients (48% White, 34% male) reported adherence to medications, diet, exercise, smoking, and home blood pressure monitoring. A latent class analysis approach was used to identify subgroups that adhere to these five self-management behaviors. Fit statistics suggested two latent classes. The first class (labeled "more adherent") included patients with greater probability of adhering to recommendations compared with the second class (labeled "less adherent") with regard to nonsmoking (97.7% versus 76.3%), medications (75.5% versus 49.5%), diet (70.7% versus 46.9%), exercise (63.4% versus 27.2%), and blood pressure monitoring (32% versus 3.4%). Logistic regression analyses used to characterize the two classes showed that "more adherent" participants were more likely to report full-time employment, adequate income, and better emotional and physical well-being. Results suggest the presence of a less adherent subtype of hypertensive patients. Behavioral interventions designed to improve adherence might best target these at-risk patients for greater treatment efficiency.
    Patient Preference and Adherence 07/2010; 4:255-62. · 1.49 Impact Factor
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    Brian J Ayotte, Frances M Yang, Richard N Jones
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    ABSTRACT: This study examined the associations among chronic health conditions, sociodemographic factors, and depressive symptomatology in older married couples. Data from the 2004 wave of the Health and Retirement Study (n = 2,184 couples) were analyzed. Results indicated a reciprocal relationship in depressive symptoms between spouses. Additionally, post hoc analyses indicated that husbands' stroke and high blood pressure were related to increased depressive symptomatology among wives. Beyond the reciprocal relationship, husbands were unaffected by wives' health. These results suggest sex differences underlying psychological distress in the context of physical health among older adults and that older women with husbands who have high levels of depressive symptomatology, high blood pressure, or a history of stroke may be at particular risk of experiencing depressive symptoms.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 07/2010; 65(4):438-48. DOI:10.1093/geronb/gbq033 · 2.85 Impact Factor
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    Brian J Ayotte, Nancy R Kressin
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    ABSTRACT: Race differences in the receipt of invasive cardiac procedures are well-documented but the etiology remains poorly understood. We examined how social contextual variables were related to race differences in the likelihood of receiving cardiac catheterization in a sample of veterans who were recommended to undergo the procedure by a physician. Prospective observational cohort study. A subsample from a study examining race disparities in cardiac catheterization of 48 Black/African American and 189 White veterans who were recommended by a physician to undergo cardiac catheterization. We assessed social contextual variables (e.g., knowing somebody who had the procedure, being encouraged by family or friends), clinical variables (e.g., hypertension, maximal medical therapy), and if participants received cardiac catheterization at any point during the study. Blacks/African Americans were less likely to undergo cardiac catheterization compared to Whites even after controlling for age, education, and clinical variables (OR = 0.31; 95% CI, 0.13, 0.75). After controlling for demographic and clinical variables, three social contextual variables were significantly related to increased likelihood of receiving catheterization: knowing someone who had undergone the procedure (OR = 3.14; 95% CI, 1.70, 8.74), social support (OR = 2.05; 95% CI, 1.17, 2.78), and being encouraged by family to have procedure (OR = 1.45; 95% CI, 1.08, 1.90). After adding the social contextual variables, race was no longer significantly related to the likelihood of receiving catheterization, thus suggesting that social context plays an important role in the relationship between race and cardiac catheterization. Our results suggest that social contextual factors are related to the likelihood of receiving recommended care. In addition, accounting for these relationships attenuated the observed race disparities between Whites and Blacks/African Americans who were recommended to undergo cardiac catheterization by their physicians.
    Journal of General Internal Medicine 04/2010; 25(8):814-8. DOI:10.1007/s11606-010-1324-y · 3.42 Impact Factor
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    ABSTRACT: This study tests the associations of self-efficacy, outcome expectancies, perceived barriers, self-regulatory behaviors and social support with physical activity. Data from 116 married community-dwelling middle-aged and young-old couples (M = 58.86 years, SD = 7.16, range = 50 to 75) were collected via mail-in survey. The model indicated that self-efficacy was directly and indirectly related to physical activity through outcome expectancies, perceived barriers and self-regulatory behaviors. The results clarify the associations among the social cognitive constructs and physical activity, and suggest that interventions targeting multiple social cognitive constructs could increase the activity levels of middle-aged and young-old adults.
    Journal of Health Psychology 03/2010; 15(2):173-85. DOI:10.1177/1359105309342283 · 1.88 Impact Factor
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    ABSTRACT: Depression is often associated with decreased cognitive performance among older adults. The current study focused on the association of neuropsychological functioning and personality traits in depressed and non-depressed older adults. Data from 75 depressed and 103 non-depressed adults over the age of 60 were analyzed. All participants underwent standardized clinical assessment for depression prior to participation and completed the NEO-PI-R and a series of neuropsychological assessments. A series of multiple linear regressions were conducted to examine the relationships between personality and neuropsychological performance among depressed and non-depressed older adults. Results indicated that higher Openness to Experience was related to better performance on Parts A and B of the Trail Making Test among depressed older adults, and to better Digit Span Backward performance among all participants. Higher levels of neuroticism were related to poorer performance on Digit Span Backward, but only among depressed older adults. Depressed participants performed more poorly on the Symbol Digit Modalities Test and the Controlled Oral Word Association Test. Personality characteristics, particularly Openness to Experience, modified the relationship between depression and neuropsychological functioning among older adults. Results indicate that interventions aimed at increasing one's Openness to Experience could potentially attenuate some of the neuropsychological impairments that are associated with depression.
    International Journal of Geriatric Psychiatry 09/2009; 24(9):1010-9. DOI:10.1002/gps.2213 · 3.09 Impact Factor
  • Brian J Ayotte, Jason C Allaire, Hayden Bosworth
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    ABSTRACT: We examined the mediating role of health literacy in the relationships between participant demographic characteristics and health information recall. Baseline data from two studies that focused on hypertensive adults (N = 1190; M = 62.28 years, SD = 11.98; 35.5% female; 45.9% African-American) were analyzed. The final model, which adjusted for recruitment site, indicated that financial status, race, and education were indirectly related to health information recall through health literacy. Increasing education was also directly related to better health information recall. Increasing age was not related to health literacy, but was related to poorer health information recall. The final model fit the data very well, chi(2)(3) = 0.69, p = .36, RMSEA = .000 (90% CI = .000 to .024), CFI = 1.00. The results suggest that health literacy might be one of the mechanisms underlying the relationships between participant demographic characteristics and poor health outcomes due to inaccurate recall of instructions.
    Aging Neuropsychology and Cognition 06/2009; 16(4):419-32. DOI:10.1080/13825580902741336 · 1.07 Impact Factor
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    Brian J Ayotte, Ranak Trivedi, Hayden B Bosworth
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    ABSTRACT: Health-related knowledge is an important component in the self-management of chronic illnesses. The objective of this study was to more accurately assess racial differences in hypertension knowledge by using a latent variable modeling approach that controlled for sociodemographic factors and accounted for measurement issues in the assessment of hypertension knowledge. Cross-sectional data from 1,177 participants (45% African American; 35% female) were analyzed using a multiple indicator multiple causes (MIMIC) modeling approach. Available sociodemographic data included race, education, sex, financial status, and age. All participants completed six items on a hypertension knowledge questionnaire. Overall, the final model suggested that females, Whites, and patients with at least a high school diploma had higher latent knowledge scores than males, African Americans, and patients with less than a high school diploma, respectively. The model also detected differential item functioning (DIF) based on race for two of the items. Specifically, the error rate for African Americans was lower than would be expected given the lower level of latent knowledge on the items, on the questions related to: (a) the association between high blood pressure and kidney disease, and (b) the increased risk African Americans have for developing hypertension. Not accounting for DIF resulted in the difference between Whites and African Americans to be underestimated. These results are discussed in the context of the need for careful measurement of health-related constructs, and how measurement-related issues can result in an inaccurate estimation of racial differences in hypertension knowledge.
    Ethnicity & disease 02/2009; 19(1):23-7. · 0.92 Impact Factor
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    ABSTRACT: To examine the performance subjects with and without mild cognitive impairment (MCI) on an objective measure of everyday or real-world memory and subjective items assessing competency within the same instrumental domains; to determine whether the Everyday Cognition Battery (ECB) can uniquely predict MCI status. Cross-sectional. Independent-living sample of urban dwelling elders in Baltimore Maryland. The sample consisted of 555 subjects ranging in age from 50 to 95 (mean 68.8 +/- 9.6). Objective performance in three instrumental domains (medication use, financial management, nutrition and food preparation) was assessed using the ECB Memory Test. Subjective performance within the same instrumental domains was also assessed. No difference was found between elderly subjects with and without MCI on the subjective items of instrumental activity of daily living (IADL) competency. A significant multivariate effect for cognitive status group (F(3, 507)=21.88, P<.05, eta(2)=.12) was observed for the objective measure, with participants with MCI performing, on average, significantly worse than those without on all thee instrumental domain subscales. The medicine use (odds ratio (OR)=0.96, 95% confidence interval (CI)=0.94-0.99) and financial management (OR=0.93, 95% CI=0.91-0.96) subscales of the ECB Memory Test were unique and significant predictors of MCI. This study adds to the growing body of literature suggesting that cognitively complex IADLs might be compromised in elderly people with MCI. Moreover, the ECB Memory Test might be a clinically useful tool in evaluating real-world competency.
    Journal of the American Geriatrics Society 11/2008; 57(1):120-5. DOI:10.1111/j.1532-5415.2008.02054.x · 4.22 Impact Factor
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    ABSTRACT: We were interested in examining the relationship between psychosocial factors and hypertension-related behaviors. We hypothesized that lower emotional well-being and unmarried status would be related to higher BP, poorer medication adherence, greater difficulty adhering to diet and exercise, and current smoking. In a cross-sectional design, 636 hypertensive patients completed the Mental Component Summary (MCS) Scale of the SF-12 and rated their difficulty with adherence to diet, exercise, and medication-taking. In logistic regression analyses, lower MCS scores were associated with difficulty adhering to diet (OR = 0.97, p < .05) and exercise (OR = 0.97, p < .01), and current smoking status (OR = 0.98, p < .05). Being married was associated with higher probability of medication adherence (OR = 1.66, p < .01) and a lower probability of being a current smoker (OR = 0.34, p < .0001). Neither MCS scores nor being married were related to BP levels in adjusted analyses. Results emphasize the importance of assessing psychosocial factors to optimize hypertension treatment.
    Journal of Behavioral Medicine 09/2008; 31(6):489-97. DOI:10.1007/s10865-008-9173-4 · 3.10 Impact Factor
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    ABSTRACT: Older adults, the primary consumers of prescription medications in the United States, may be particularly prone to medication side effects. The present study examined the relation between change in prescriptions and change in cognitive performance (i.e., inductive reasoning and everyday problem solving), as well as how three common classes of medication (i.e., cardiovascular, hormone/synthetic substitutes, and central nervous system agents) were related to cognitive performance. Data were collected from 78 community-dwelling older adults (M = 71.14 years, SD = 5.35) over an 18-month period. Results indicated that types of drugs were differentially related to cognitive change and that the total number of prescriptions was related to change in cognitive performance. Clinical and research advantages of using specific cognitive and prescription assessments, rather than more global measures, are discussed.
    Clinical Gerontologist 05/2008; 31(4):97-121. DOI:10.1080/07317110802143974 · 0.66 Impact Factor
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    ABSTRACT: Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts. The present study investigated the effects of a debiasing procedure designed to prevent the framing effect for young adults who made decisions based on hypothetical medical decision-making vignettes. The debiasing technique involved participants listing advantages and disadvantages of each treatment prior to making a choice. One hundred and two undergraduate students read a set of three medical treatment vignettes that presented information in terms of different outcome probabilities under either debiasing or control conditions. The framing effect was demonstrated by the control group in two of the three vignettes. The debiasing group successfully avoided the framing effect for both of these vignettes. These results further support previous findings of the framing effect as well as an effective debiasing technique. This study improved upon previous framing debiasing studies by including a control group and personal medical scenarios, as well as demonstrating debiasing in a framing condition in which the framing effect was demonstrated without a debiasing procedure. The findings suggest a relatively simple manipulation may circumvent the use of decision-making heuristics in patients.
    Patient Education and Counseling 05/2008; 71(1):102-7. DOI:10.1016/j.pec.2007.11.004 · 2.60 Impact Factor
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    ABSTRACT: Lifestyle behaviors such as reducing weight if overweight or obese, reducing salt intake, exercising, reducing alcohol intake, quitting smoking, and eating a healthy diet are related to the prevention and control of chronic diseases. However the amount of lifestyle advice provided by clinicians has been declining over the last decade. In 2002, a telephone survey was conducted to assess the quality of preventive care offered by health care providers. The study was a cross-sectional observational study of a randomly selected sample of 516 diverse individuals in Durham County, North Carolina. Information regarding age, sex, race, education, health conditions, and self-reported receipt of lifestyle advice was examined in the study. The odds of receiving advice to engage in preventive lifestyle behaviors were significantly higher for those with a pre-existing diagnosis of diabetes or hypertension and for participants reporting poor health status. For example, the odds of receiving advice to control or lose weight was 8.32 (95% CI, 2.65, 26.75) among individuals reporting a diagnosis of diabetes. Similarly, the odds of reporting "receiving advice to reduce salt intake" was 6.97 (95% CI, 3.74, 13.00) among subjects reporting a diagnosis of hypertension. The results are from a cross-sectional study of a sample of individuals in only one county. Additionally, the results are based on patient self-reported information, which could be subject to recall and social desirability bias. Patients with identified health problems were more likely than others to report being advised to adopt healthy lifestyle recommendations. Future research should examine methods to encourage health care providers to offer lifestyle advice to those without pre-existing illness.
    North Carolina medical journal 70(5):391-8.

Publication Stats

173 Citations
38.95 Total Impact Points


  • 2012–2015
    • University of Massachusetts Dartmouth
      • Department of Psychology
      New Bedford, Massachusetts, United States
  • 2010
    • U.S. Department of Veterans Affairs
      Washington, Washington, D.C., United States
    • Phoenix VA Health Care System
      Phoenix, Arizona, United States
  • 2009
    • Duke University
      Durham, North Carolina, United States
  • 2008
    • Minneapolis Veterans Affairs Hospital
      Minneapolis, Minnesota, United States