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Age- and education-related effects on cognitive functioning in Colored South African women
Abstract
We, the Editors and Publisher of Aging, Neuropsychology and Cognition have retracted the following article:
Age- and education-related effects on cognitive functioning in Colored South African women by Sharné Nieuwoudt, Kasha Elizabeth Dickie, Carla Coetsee, Louise Engelbrecht & Elmarie Terblanche, Aging, Neuropsychology and Cognition, 2019, DOI:10.1080/13825585.2019.1598538
While this article was peer-reviewed and accepted according to the Journal’s policy, it has subsequently been determined that serious flaws exist in the methodology and reporting of the original study. In summary the article contains a number of assertions about ‘colored’ South African women based on the data presented that cannot be supported by the study or the subsequent interpretation of its outcome. Specific data that would be relevant to these assertions was not collected. In addition, the references provided are not supportive of the claims that are made about the participants in the study or about South African women more generally.
Consequently, the Editors and the Publisher have taken the decision to retract this article. We have consulted with the Authors throughout this process and they have agreed with the retraction of this article.
We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions.
The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”.
... The natural history of tuberculous pericarditis has been previously described, including treatment options to prevent progression to constriction. 16,[27][28][29][30] In this study we found few differences in the clinical profile between HIV-positive and -negative patients. The higher levels of alkaline phosphatase and gamma glutamyl transferase among HIV-positive patients might have been due to hepatic tuberculosis or more likely to more severe hepatic congestion in these subjects. ...
... This finding differs from studies in patients with tuberculous pericarditis co-infected with HIV who have been found to have a higher prevalence of myopericarditis. 27,31 Preservation of ejection fraction might explain why we found no significant differences in peri-operative mortality rate observed between HIV-positive and -negative patients. It is also likely that antiretroviral therapy in our patients may have helped to preserve left ventricular function by preventing the development of opportunistic infections or HIV-associated myocardial dysfunction. ...
... 14 On the other hand, the influence of African culture may mean that women are employed in domestic work, which is typically associated with minimal and light-tomoderate intensity physical activity, which is especially so in black township communities in South Africa. 27 Therefore within low-income communities, where most men are usually involved in unskilled manual labour, it is expected that they would have higher levels of physical activity than the women. ...
Familial hypercholesterolaemia (FH) is a common autosomal dominantly inherited disorder in which impaired clearance of plasma low-density lipoprotein cholesterol causes premature atherosclerotic vascular disease and tendon xanthomata. This workshop aimed to consolidate information on the diagnosis and management of FH in South Africa. The genetic causes include mutations in the LDL receptor, apolipoprotein B100 and proprotein convertase subtilisin/kexin type 9 (PCSK9). Additionally, the concatenation of multiple gene variants can result in polygenic FH. Therapeutic measures include a healthy lifestyle, statins and cholesterol-absorption inhibitors that will achieve control of the dyslipidaemia in the majority of cases. The recently introduced monoclonal antibodies to PCSK9 can improve achievement of target concentration in severe cases. FH is present in all sectors of the South African population but there is sparse documentation in the indigenous African populations. FH should be actively sought, diagnosed and treated with judicious pharmacotherapy and screening of relatives.
... There has been justified outraged about a recently published article entitled Age-and educationrelated effects on cognitive functioning in Colored South African women, authored by five academics associated with the Department of Sport Science at Stellenbosch University. The authors, Nieuwoudt, Dickie, Coetsee, Engelbrecht and Terblanche (2019), argue that "colored women in South Africa have an increased risk for low cognitive functioning as they present with low education levels and unhealthy lifestyles". Based on public outcry, including a petition signed by thousands, the article was retracted by the journal, Aging, Neuropsychology and Cognition (https://www.tandfonline.com/doi/abs/10.1080/13825585.2019.1598538). ...
... Some of the criticisms include: that the Le Grange A comment on critiques of the article Age-and education-related effects on cognitive functioning in Colored South African women 10 research depicted in the article smacks of racial essentialism; that the authors commit a perennial error evident in biomedical sciences research to connect race with medical conditions (Jansen, 2019a); that the research has methodological flaws, including its sample size (Shange, 2019); that the findings of the research is painful to women who were designated Coloured during apartheid and has elicited anger (Kassen, 2019); that the research is a product of an institution that has a long history of producing racial science, and that there is an enduring racism in science (Kuljian, 2019); that serious questions should be asked about the peer-review processes that the research was subjected to, including the work of the Research Ethics Committee (REC) at Stellenbosch University (Dano, 2019); and so forth. I support much of the criticism levelled against the research produced by Nieuwoudt et al. (2019). However, there are some matters invoked by critics on which I shall provide critical comment. ...
... One of the themes that has emerged from criticisms levelled against the Nieuwoudt et al. (2019) article is "race science". Variations of the term were used by panelists at the Stellenbosch University symposium I mentioned earlier: "racial science" (Jonathan Jansen); "scientific racism" (Handri Walters); and "race-based science" (Babara Boswell). ...
... I aver that our response to racism in science should not concern merely exorcising racism from science content but that modern western science needs to be decolonised. Furthermore, an analysis of peer-review and ethical regulation in the Nieuwoudt et al. (2019) case should not focus simply on whether reviewers did their work or not, but that the dominant systems of peer-review and ethics creep in the neoliberal university should come under scrutiny. ...
... Some of the criticisms include: that the Le Grange A comment on critiques of the article Age-and education-related effects on cognitive functioning in Colored South African women 10 research depicted in the article smacks of racial essentialism; that the authors commit a perennial error evident in biomedical sciences research to connect race with medical conditions (Jansen, 2019a); that the research has methodological flaws, including its sample size (Shange, 2019); that the findings of the research is painful to women who were designated Coloured during apartheid and has elicited anger (Kassen, 2019); that the research is a product of an institution that has a long history of producing racial science, and that there is an enduring racism in science (Kuljian, 2019); that serious questions should be asked about the peer-review processes that the research was subjected to, including the work of the Research Ethics Committee (REC) at Stellenbosch University (Dano, 2019); and so forth. I support much of the criticism levelled against the research produced by Nieuwoudt et al. (2019). However, there are some matters invoked by critics on which I shall provide critical comment. ...
... One of the themes that has emerged from criticisms levelled against the Nieuwoudt et al. (2019) article is "race science". Variations of the term were used by panelists at the Stellenbosch University symposium I mentioned earlier: "racial science" (Jonathan Jansen); "scientific racism" (Handri Walters); and "race-based science" (Babara Boswell). ...
... This legal classification was created during Apartheid in South Africa and has remained a legal classification in South Africa until the present (Adhikari, 2006;Isaacs-Martin, 2018). The article by Nieuwoudt et al. (2019) was petitioned and later retracted by the publishers as it was heavily criticised for perpetuating racist and sexist ideologies as well as colonial stereotypes, with Apartheid underpinnings, of coloured women. The uncritical use of the term coloured to homogenise a racially diverse group of women was found in the article (Boswell, Erasmus, Johannes, Mahomed, & Ratele, 2019). ...
... In this article, the use of intersectionality (Crenshaw, 1988) allows the author to focus predominantly not only on gender but also on language as another factor that can affect performance in assessment. Although there have been important developments and interventions to guide test developers and test users on the fairness, validity and reliability of assessments, the retracted research study by Nieuwoudt et al. (2019) reminds us of the importance of continually validating assessments in the South African context. For this reason, this study was guided by two research questions, namely: are there any differences in the performance of men and women in the ECT? and what is the interaction effects of gender and language on the ECT total score? ...
Orientation: The empirically designed English Comprehension Test (ECT) is theorised to measure verbal reasoning and is currently undergoing validation. The test development produced two versions of the ECT, namely, ECT version 1.2 and ECT version 1.3. This study focuses on the latest test version, ECT version 1.3.
Research purpose: The purpose of this study was to statistically explore the performance of men and women who were assessed by the empirically designed ECT.
Motivation for the study: Cognitive assessment has often been used as a discriminatory tool against gender, race and/or languages. The discrimination against race and gender were the consequences of a patriarchal system and Apartheid in South Africa, as black men and women were deemed to be subordinate to white men. With the demise of Apartheid, measures have been put in place to guard against unfair assessment practices. In addition, legislation was developed to ensure that test developers and test users employed assessments that did not unfairly prejudice individuals based on their race, gender and language. These measures are imperative to ensure fairness and equal opportunities for men and women across race and language groups.
Research design, approach and method: This study used a quantitative cross-sectional design. The ECT was administered to a non-probability convenience sample of 881 individuals. The data were analysed by differential test functioning (DTF) in Winsteps and analysis of variance (ANOVA) in the Statistical Product and Service Solutions (SPSS) package.
Main findings: The results indicated that the majority of the test items did not present any bias, but five possibly biased items were identified across gender groups in the test. These five items that were possibly biased appear to be affected by language and not gendered knowledge, and this, however, necessitates further investigation. The ANOVA results only indicated statistically significant differences across the different language groups, thereby confirming the DTF results.
Practical/managerial implications: A major limitation of this study is the restriction of range and lack of generalisability.
Contribution/value-add: This study promotes the use of DTF and ANOVA as a means of ensuring fairness in assessment practices across gender groups. Moreover, it contributes to cross-cultural test development and validation research in South Africa.
... TransacTional eThics and "damage-cenTred" research: of banaliTy and oblivion absTracT The recent article by Nieuwoudt, Dickie, Coetsee, Engelbrecht and Terblanche (2019) entitled "Age-and education-related effects on cognitive functioning in Colored South African women" published in the journal Aging, Neuropsychology, and Cognition, attracted considerable negative attention, leading to its official withdrawal from circulation. While it may be argued that this unfortunate piece of "scholarship" had "slipped through the cracks", there is certainly a need for a more nuanced analysis of what constitutes ethical social research practice. ...
... The article by Nieuwoudt et al. (2019) was an important trigger piece that has reawakened the somewhat complacent level of engagement on ethics as it relates to research in South Africa. The purpose of this current article is not an analysis of the specifics of the contents of this withdrawn article, and neither is it meant to be an attack on these colleagues per se. ...
The recent article by Nieuwoudt, Dickie, Coetsee, Engelbrecht and Terblanche (2019) entitled “Age- and education-related effects on cognitive functioning in Colored South African women” published in the journal Aging, Neuropsychology, and Cognition, attracted considerable negative attention, leading to its official withdrawal from circulation. While it may be argued that this unfortunate piece of “scholarship” had “slipped through the cracks”, there is certainly a need for a more nuanced analysis of what constitutes ethical social research practice. In this article, the issue of intentionality and (un)witting Othering is contemplated by invoking Tuck’s notion of “damage-centred” research, an approach that continues to frame contemporary investigations in the name of social justice. It is argued that there is a need to reconsider the practice of transactional ethics. Arendt’s concept of the banality (of evil) has resonance, as it speaks to the notion of “blissful oblivion of complicity”, even in the context of a widespread contemporary discourse of social transformation and decolonisation in South African higher education
... Stellenbosch Üniversitesi'nde yapılan bir çalışmada siyahi olmayan Güney Afrikalı kadınlarda bilişsel işlevlere odaklanılmıştır. 89 Aynı çalışmada ırksal önyargıların, belirli ırk gruplarının diğerlerinden daha az seviyede bilişsel yeteneğe sahip olduğuna dair olası bir kalıplaşmış algıya işaret ettiği ortaya çıkmıştır. Cape Town Üniversitesi'nde gerçekleştirilen ikinci çalışma ise Afrika'daki istihbarat ve köle ihracatına odaklanmıştır. ...
ÖZET
Bilinç; gerçek zamanlı ve spontan ya da tasarlanmış zihinsel eylemlerin, normatif ve yapılandırılmış entegratif içsel ve dışsal değerlendirmeler yoluyla hem geçmiş hem de gelecekteki olası durumlara göre içinde yaşanan an odaklı optimize edilmesiyle
deneyimlenerek kontrol edilebilen çok bileşenli psikojen bir fenomendir. Öznel ve nesnel harmonisiyle kişiye özgü bir deneyim olan bilincin tekilliği, deneysel açıdan doğrulanabilecek bir fenomen değildir. Bilincin bir “tekillik yaşantısı” sayılmasına
ilişkin bütün kısıtlamalar ve eleştiriler karşısında “çoklu bilinç sistemi” merkezli “Psikotoplumsal Bilinç Alyansı Kuramı”nın inşası bir zorundalık haline gelerek bu konuda yakınsak ve bütünsel bir metodoloji ile birlikte “derin bilinç” kavramını
da içeren alternatif bir yaklaşım olarak Öztürk tarafından önerilmiştir. Aynı zamanda bu çalışmada Öztürk, “Dissosiyatif Yansıtımlı Kimlik Geçişi Kuramı” ile “İnkar Travması” ve “Travma Dikotimisi” fenomenlerini yapılandırmıştır. Dissosiyatif yansıtımlı
kimlik geçişi, kişinin kendi kimliğinin özvarlanışındaki reddettiği parçalarının bir başkasının kimliğine zorla empoze edilmesi arzusunu bir “gerçeklik içbilişsel çarpıtması” ekseninde eyleme dönüşmesidir. Travmatik yaşam deneyimlerinin yok farz edilmesinin yarattığı dissosiyatif kuşatmanın bireyi mutlak gerçekliğin idrakinden uzaklaştırarak farklı ve çoklu gerçekliklere hapsetmesi, inkar travmasının ta kendisidir! İnkar kadar bireyleri ve toplumları hem gerçeklikten, hem bilinçlerinden hem de kendilerinden uzaklaştıran bir şey daha yoktur ki hatta inkar bir gerçeklik katliamıdır. Gerçeklik fenomenine hissizleşmek
ise, düşünce ve davranışlardaki psikovital duygu varlanışından vazgeçmek demektir. Travma dikotomisi, karşılaşılan en sarsıcı olumsuz örselenme ihtimalinin varlanışı esnasında ya da hemen sonrasında bireylerin tekil olduğu varsayılan bilinçlerinin
“dual bilinç sistemi”ne geçiş yapması süreci ve dissosiyojen bir yaşam deneyimidir. “Psikotoplumsal Bilinç Alyansı Kuramı” ya da diğer ismiyle “Travmatik Anılardan Uzaklaştırıcı Olağan Yaşam Deneyimleri Kuramı” ülkemizin ilk dissoanalisti olan
ve beş binin üzerinde dissosiyatif bozukluk vakalarının psikoterapilerini yüksek bir başarı ortalaması ve kesinleşmiş pozitif tedavi sonuçlarıyla tamamlayan Öztürk tarafından 2017-2022 yılları arasında geliştirilmiştir. Bilinç kavramına ve travmatik yaşantılarla
eşlenik çoklu bilinç sistemi fenomenine dair bireysel ve toplumsal her ögeyle en yakın etkileşimsel dinamiğe sahip bir eksende yapılandırılan “Dissoanaliz Kuramı”, bir travma terapisti, bir psikotarihçi ve bir dissoanalist olan Öztürk’ün uzun dönemli dissoanalitik yönelimli klinik ve teorik çalışmalarından bilimsel köken almıştır. Bu kuramdaki ana kavramlar Öztürk tarafından yine kendi geliştirdiği “Dissoanaliz Kuramı” yönelimindeki paradigma ve modaliteler ışığında yaratıcı, yansıtıcı ve
hem ıraksak hem de yakınsak bir düşünme stili odağında tanımlanmış olup bu kuramla ilişkili ikincil kavramlar ise, hermenötik ve entegratif bir yaklaşımla yeniden analiz edilmiştir.
Anahtar Kelimeler: Dissoanaliz kuramı; psiktoplumsal bilinç alyansı; dissosiyatif yansıtımlı kimlik geçişi; dissosiyasyon; psikotravmatoloji; inkar travması; psikokomünal dissosiyasyon; sosyal dissosiyasyon; toplumsal dissosiyasyon; çoklu bilinç sistemi; travma dikotomisi; hipotetik inkar; kitlesel dissosiyasyon; psikotoplumsal terapi
ABSTRACT
Consciousness is a multi-component psychological phenomenon that can be experienced and controlled by optimizing real-time and spontaneous or designed mental actions through normative and structured integrative internal and external evaluations, focusing on the present, according to both past and future possible situations. The singularity of consciousness, which is a personal experience with its subjective and objective harmony, is not a phenomenon that can be verified experimentally. In the face of all the restrictions and criticisms regarding consciousness as a "singularity experience", the construction
of the "Theory of Psychosocial Consciousness Alliance" based on "multiple consciousness system" has become a necessity; and an alternative approach, which includes the concept of "deep consciousness" along with a convergent and holistic methodology, has been proposed by Öztürk. The “Theory of Dissociative Projective Identity Transition”, “denial trauma” and “trauma
dichotomy” were also structured by Öztürk. Dissociative projective identity transition refers to the transformation of the desire of one person to impose the parts that they reject in their own identity to another's by force into action, on the axis of an "internal
cognitive distortion of reality". The dissociative siege created by the ignoring the traumatic life experiences, keeping the individual away from the realization of absolute reality and imprisoning them in different and multiple realities, is the denial
trauma itself. There is nothing that distances individuals and societies from reality, their consciousness and themselves as much as denial. Denial is a massacre of reality. To become numb to the phenomenon of reality, on the other hand, means to give up
the psychovital emotional presence in thoughts and behaviors. Trauma dichotomy is a dissociative life experience and the process of transition of individuals' supposedly singular consciousness to the "dual consciousness system" during or immediately
after the most shocking possibility of trauma encountered. The “Theory of Psychosocial Consciousness Alliance” or the “Theory of Traumatic Memory Repellent Ordinary Life Experiences” was developed by Öztürk between 2017-2022, the first dissoanalyst
of our country, who completed the psychotherapy of over five thousand dissociative disorder cases with a high success average and definite positive treatment results. The "Theory of Dissoanalysis", structured on the axis that has the closest interactional
dynamic with every individual and social element regarding the concept of consciousness and the phenomenon of the multiple consciousness system conjugated with traumatic experiences, has a scientific origin from the long-term dissoanalytically
oriented clinical and theoretical studies of Öztürk, a trauma therapist, psychohistorian, and dissoanalyst. The main concepts in this theory were defined by Öztürk in a creative, reflective and both divergent and convergent thinking style in the light of the paradigms and modalities in his "Theory of Dissoanalysis", and the secondary concepts related to this theory were theorized and reanalyzed with a hermeneutic and integrative approach.
Keywords: Theory of dissoanalysis; psychosocial consciousness alliance; dissociative projective identity transition; dissociation; psychotraumatology; denial trauma; psychocommunal dissociation; social dissociation; societal dissociation; multiple consciousness system; trauma dichotomy; hypothetical denial; mass dissociation; psychosocial therapy
... I believe that the lack of such holisticorientated curricula and training within the STEM disciplines can help explain the justifiable recent outcry against two research studies published by SU and UCT scientists. In the first study, SU researchers came to the conclusion that non-white women possessed a lower cognitive function that was influenced by their degree of education (Nieuwoudt, Dickie, Coetsee, Engelbrecht & Terblanche, 2020). This article has since been retracted by the publishing journal. ...
This book is a significant contribution to higher education globally in doing transformation and doing change in institutional culture. It is a powerful reference point and resource for transformation offices/social justice units in South Africa and globally as we continue to engage with the hard science of change. The book provides insight into the specific choices made by Stellenbosch University in relation to its location and healing institutionally harmed communities.
... This term better describes the persistence of racism, inequality and the exclusion of the black majority in present-day South Africa (Ndlovu-Gatsheni 2017a), This inequality continues to define power relations and knowledge production in South African universities. How else can one begin to explain the recent debacle at Stellenbosch University, where a peer-reviewed published study queried the intellect of coloured South African women (Nieuwoudt et al. 2020)? That this article has since been retracted by the Aging Neuropsychology and Cognition journal should not disguise the disturbing fact that such a study was conceived, sanctioned at multiple levels and widely communicated, without any thought about how offensive it was to an already marginalised group of South Africans. ...
Background: Historically, the profession of physiotherapy in South Africa has closely aligned itself with our former colonial master, the United Kingdom. Whilst efforts have been made in recent years to transform our profession, numerous challenges remain. An improved understanding of the topic of decoloniality is a useful and necessary way of beginning to address these challenges.
Objectives: The aim of this opinion piece is to encourage further dialogue amongst South African physiotherapists working in all sectors – a dialogue that must focus on genuinely transforming our profession to be better suited to serving the majority of South Africans.
Method: Global and local literature related to decoloniality is summarised for readers, followed by a closer scrutiny of how this topic relates to some of the challenges faced by the profession of physiotherapy in South Africa.
Results: The evidence presented demonstrates that whilst some efforts have been made to transform South African physiotherapy, significant work and dialogue is required to bring about a true transformation of the profession.
Conclusion: An honest and transparent conversation about decoloniality and transformation can assist in realising the potential of our profession, thereby improving the health and well-being of all South Africans.
Clinical implications: Real engagement with this topic can assist in transforming who enters our profession, what we teach, where and why we conduct research and how we can ensure that physiotherapy practice contributes to real social justice by benefitting the majority of our population.
... In 2019, the South African media reported on a study by the Stellenbosch University's Department of Sport Science that claimed that "coloured women in South Africa have an increased risk for low cognitive functioning, as they present with low education levels and unhealthy lifestyle behaviours". 4 While many South Africans were indeed shocked that such a sweeping (and unscientific) generalisation could be inferred from a small sample of 60 women, for others this was hardly surprising, given the vast number of books, research reports and journal articles produced at Stellenbosch University on the social, economic, cultural and psychological characteristics of "the coloured population". Such studies have tended The Boomerang | | 43 | to be based on the essentialist idea that this culturally and biologically homogenous group needed to be "rescued" from a litany of endemic pathologies. ...
... They argue that "the coloured community is, in terms of social class, considered the most homogenous group in South Africa and are generally described as a poor, lower working-class community". 2 Such a gross generalisation flattens the fluidity and provisional nature of "coloured" identity, which is generally taken as a socially constructed racial category by critical race theorists. ...
... But delinking also involves unearthing the positionality and power dynamic between researcher and researched and how researcher and researched are differently positioned along positionality markers of race, class, and gender (Nakata, Nakata, Keech, & Bolt, 2012). In the South African context, there was huge controversy surrounding an article published in 2019 (now retracted) by academics at the University of Stellenbosch, "Age-and Education-Related Effects on Cognitive Functioning in Colored South African Women" (Nieuwoudt, Dickie, Coetsee, Engelbrecht, & Terblanche, 2019). The article has been widely criticized not only for its colonial and racist use of the term intelligence but also for the harmful stereotypes and colonial representations of colored women by the researchers and the positioning of the researched as part of the colored community. ...
In the context of global curriculum transformation and from a global South perspective, this article explores the imposed and self-created borders that continue to “discipline” us into reproducing scholarly processes, practices, and traditions that privilege dominant forms of knowledge making and knowing in teaching and learning. Drawing on Africa as a case study to explore a framework for thinking outside borders, the author invites the reader to embrace a global social imagination that disrupts and transcends the epistemic, social, and cultural borders designed to produce knowledge that is ahistorical and decontextualized. Using a social mapping of how we thrive on neatly delineated borders that detach the known from the knower by marginalizing or delegitimizing knowledges of the Other, this article, which draws on an earlier version presented as a keynote at the 16th annual conference of the International Society for the Scholarship of Teaching and Learning in Atlanta, Georgia, USA, presents a theory of change geared toward borderless, decolonized, socially just, and inclusive pedagogy and scholarship.
... In the current South African environment, however, racial confounding in science led to the retraction of a controversial article that was recently published. 27 Unfortunate events like these may hamper expedient ethical approval of BP studies investigating different racial responses to antihypertensive treatment. ...
The purpose of this review is to update the reader on the relevance of autonomic nervous system imbalance in clinical cardiology. Increased sympathetic tone associates with the metabolic syndrome, hypertension and cardiac arrhythmias. With the kidneys playing a pivotal role in increased peripheral resistance, sodium and water retention and other mechanisms, renal denervation (RD) may theoretically restore autonomic imbalance and improve cardiovascular outcomes. Landmark RD trials and novel uses for RD in cardiac arrhythmia management are discussed.
There is a body of education scholarship in South Africa that captures the role played by social movements in democratising education in post-apartheid South Africa. However, this scholarship says little about how power dynamics affect learning and intellectual labour in social movements or social movement organisations. In addition, the issue of learning in social movements or social movement organisations is hardly explored in the South African social movement literature. This lack of focus on how activists, especially grassroots activists in working-class communities, learn and produce knowledge in social movements and organisations obscures the complexity of learning and knowledge production in activist settings. This article explores how activists, especially grassroots activists, learn in social movements. Based on secondary literature and interviews, the article advances two main arguments: First, learning in social movements and organisations takes place in non-formal and informal ways. Both these forms of learning take place inside and outside formal educational settings. And they both contribute to the empowerment and critical consciousness of activists in social movements and organisations. In addition, informal learning takes place inside and outside popular educational spaces. However, it is not inevitable that non-formal and informal forms of learning in activist settings will generate critical knowledge and activist practices that disrupt the status quo. Second, power relations based on “race”, social class, gender, and sexuality, among other axes of social division, impact on how learning takes place in non-formal or popular contexts of education. This article seeks to understand how power relations shape the learning and knowledge production process in social movements and organisations.
Ethical research behaviour plays an essential role in ensuring the integrity of knowledge. Consequently, ethical transgressions during the research process negatively influence the knowledge produced, and have wider social consequences for various stakeholders in society. To honour the value and role of ethical research for individuals and society, researchers are required to display ethical judgement and ethically responsible research behaviour. Doctoral students, who are considered to be significant contributors to knowledge creation, can improve the quality of their research through their ethical research behaviour. Owing to the implicit and explicit ethical practices and conflicts that can arise during the research process, the supervision process is an opportune moment for developing ethical research behaviour and ethical capabilities in doctoral students. This article focuses on developing ethical research behaviour in doctoral students, and offers pragmatic guidelines for ways in which this behaviour can be developed during the supervision process.
The influence of the frequency of reading and writing habits (FRWH) on cognition has been investigated by several studies in the literature. However, the implications of FRWH on executive development, intelligence, and academic achievement are not yet clear in adolescents with healthy development. The aim was to verify whether there are differences in executive functions, intelligence, and academic achievement between adolescents with high and low FRWH. Moreover, we aimed to investigate if there are differences in the parental FRWH between adolescents with high and low FRWH. The sample was composed of 47 healthy adolescents, n = 24 with high FRWH and n = 23 with low FRWH. Adolescents with higher FRWH had better performance on measures of vocabulary, Speech Act analysis, and Oral Narrative Discourse. Therefore, a high FRWH has a positive influence on the cognitive development of healthy adolescents, especially with regard to pragmatic language. However, adolescents with low FRWH performed better than those with a high FRWH on an automatic counting task. The interpretation of cognitive performance and academic achievement scores in neuropsychological assessment should consider the FRWH of parents and adolescents. This factor should be targeted by early stimulation interventions to help adolescents achieve the highest possible levels of global development.
The article is a review of contemporary randomized studies on radiofrequency denervation of renal arteries, followed by critical assessment of their advantages and disadvantages for possible optimization of endovascular treatment of resistant arterial hypertension.
This chapter looks at the complexities that underlie the landscape and language of academic activism. While widely understood as a feature of higher education, there is seemingly little consensus of what academic activism implies as lived endeavours, expressions and experiences for academics, as well as management and governance structures. It is, therefore, unsurprising to find that despite understanding the theoretical importance of the role of higher education in actively pursuing and espousing new forms of knowledge, reasoning and judgement, there is disagreement not only on whom and what embodies activism but certainly on whose responsibility it is and what, if any, its parameters are. We explore some philosophical reflections on the notion of academic activism, as espoused through our human experiences, as academics, in relation to the practice of encounters. Concurrently we show how these practices of academic activism connect with a philosophical paradigm of interpretivism that gives activism its rigorous potency. Thereafter, we show how the notion of philosophy of higher education should be reconsidered in line with a more tenable understanding of academic activism.
Since the publication of the now infamous paper 'Age-and education-related effects on cognitive functioning in Colored South African women' by Nieuwoudt and colleagues where they claim the cognitive functioning of coloured women is defective in some ways, there has been renewed doubts about the legitimacy of race in research... The attention which this paper has received is perhaps related to how it is a caricature of a more common and mundane problem about the status of race in research.
This Commentary is a response to a Commentary published in the May/June 2020 issue:
Nattrass N. Why are black South African students less likely to consider studying biological sciences? S Afr J Sci. 2020;116(5/6), Art. #7864, 2 pages. https://doi.org/10.17159/sajs.2020/7864
Responses to the Commentary in the May/June 2020 issue have been published collectively in a special issue of Volume 116.
The South African sport science curriculum is presented to students with content that foregrounds sport achievement but neglects institutional dilemmas. This study intervened by exposing it's racist past and capitalist nature. It done so by drawing on previous work on higher education and sport science curriculum, which analyzed curriculum as a polemical ideological construct. The analysis showed how the South African sport science field was characterised in the past and continues in the present, by a lack of critical engagement with politics of curriculum. Thus, this article calls for a decolonisation perspective on the sport science curriculum. After an introduction that explored the epistemo-logical foundations of the South African sport science curriculum, the study attempted to define the term, curriculum through a capitalist logic. Next, historical continuities and changes in the sport science curriculum was explored. Finally, the study was concluded by suggestions for consideration for future scholars and activists with a decolonised agenda.
In the field of trauma and dissociation, culture has a significant influence on the clinical presentation of patients. A growing body of literature addresses the relationship between culture and dissociation. Studies of this relationship though, evoke the important, but at the same time extremely sensitive issue of cross-cultural comparisons. In this editorial, I provide a limited overview of various ways in which cultural influences have been addressed in the field of trauma and dissociation. Most studies have examined the occurrence of dissociative disorders in clinical populations in different cultures and countries. Some have focused on normative dissociation as a response to traumatic events in non-clinical samples from different cultures. This editorial also explores the concepts of double consciousness and black consciousness, which have emerged from the fields of social psychology and black psychology; and how these concepts influence our thinking about non-clinical dissociation. Culture-related challenges in the field of trauma and dissociation create opportunities for training in cultural competence for therapists. Qualitative research methods might be best suited to future research on the relationship between culture, trauma and dissociation. The chances of reaching a thorough and deep understanding of the influence of culture on trauma and dissociation might be best if the entire spectrum of dissociation is studied – from normal to pathological dissociation, and in its different manifestations from universal to those unique to certain cultural groups.
I reply to an article in this issue of Journal of Education by Suriamurthee Moonsamy Maistry entitled, "(Re)Counting the High Cost of Predatory Publishing and the Effect of a Neoliberal Performativity Culture." In his article, Maistry confessed his "wrong-doing" in having published articles in predatory journals. He argued that he alone is to blame for his "trangressions" because academia is necessarily a critical space that demands astuteness and constant vigilance, which he failed to uphold. Through showing remorse, he hopes to restore his academic reputation, which he believes has been eroded. In my response, I address four matters: the struggle to be an ethical researcher in the neoliberal university, the contested nature of predatory publishing, peer review as a practice fraught with difficulties, and the invocation of an immanent ethics in becoming ethical. Instead of focusing only on issues of moral decline (Beall, 2012) and moral failings (Maistry, 2019), I suggest that in a digital age we should use the opportunities that open-access publishing provides for democratising academic publishing and making it as affordable to as many people as possible. This requires, as Willinsky and Alperin (2011) argued, treating the ethical domain as a realm of positive action where one goes out of one's way to help others instead of focusing on issues such as exam cheating and research fudging-in this instance, "predatory" publishing.
Background: Mild cognitive impairment (MCI) represents an intermediate state between normal cognition and dementia. Early detection and treatment of reversible contributing factors to progressive cognitive decline currently forms the cornerstone of management. As the population at risk of developing dementia is projected to increase significantly in many low- and middle-income countries where health care services continue to operate under clinical and human resource constraints, there is a need for low-cost, quick and reliable screening tools. The Montreal cognitive assessment (MoCA) was developed as a brief screening tool with high sensitivity and specificity for detecting MCI. The initial validation sample for the MoCA consisted of English and French speaking Canadians. Studies undertaken in a variety of countries show that the reliability and validity of the MoCA in screening for MCI is good; however, it has been recommended that some item modification and adjustment of cut-offs for the diagnosis of MCI in these populations may be needed to account for cultural differences.
To date, no studies have evaluated the MoCA in the South African population. We aimed to compare the validity of the MoCA to the RBANS, evaluate the effectiveness of the MoCA as a screening tool for MCI and generate normative data for the MoCA.
Methods: A cross-sectional observational study comprising a sample of 370 cognitively healthy males and females aged 18 years and older of mixed race (Coloured ethnicity) who were administered the MoCA and RBANS during screening.
Results: The MoCA showed acceptable internal consistency (Cronbach’s alpha of 0.624). MoCA scores were significantly associated with gender (r = -0.199, p = 0.000), and correlated with age (r = -0.203, p = 0.000) and education (r = 0.326, p = 0.000). There was a strong correlation between total scores on the MoCA and RBANS (r = 513; p = 0.000), indicating good criterion-related validity. The MoCA also showed good agreement with the RBANS according to the Bland–Altman plot. ROC statistics demonstrated that the performance of the MoCA for predicting MCI compared to the RBANS was fair with an AUC of 0.794. Using the recommended cut-off score of 26, the MoCA showed high sensitivity (94.23%) but low specificity (28.16%). When the cut-off score was lowered to 23, the sensitivity was 75% and specificity 66.77%, while a cut-off of 24 demonstrated a sensitivity of 84.62% and a specificity of 52.53%.
Conclusion: Although the MoCA appears fairly reliable at identifying MCI in this population, our findings suggest that some modification to certain domains and items is needed to improve the differentiation between normal ageing and MCI. Until such time that a culturally adapted version of the MoCA has been developed and validated for this population, we suggest lowering the cut-off score to 24 in order to reduce false-positive diagnoses of MCI.
Sex differences in Alzheimer's disease (AD) biology and progression are not yet fully characterized. The goal of this study is to examine the effect of sex on cognitive progression in subjects with high likelihood of mild cognitive impairment (MCI) due to Alzheimer's and followed up to 10 years in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cerebrospinal fluid total-tau and amyloid-beta (Aβ42) ratio values were used to sub-classify 559 MCI subjects (216 females, 343 males) as having "high" or "low" likelihood for MCI due to Alzheimer's. Data were analyzed using mixed-effects models incorporating all follow-ups. The worsening from baseline in Alzheimer's Disease Assessment Scale-Cognitive score (mean, SD) (9 ± 12) in subjects with high likelihood of MCI due to Alzheimer's was markedly greater than that in subjects with low likelihood (1 ± 6, p < 0.0001). Among MCI due to AD subjects, the mean worsening in cognitive score was significantly greater in females (11.58 ± 14) than in males (6.87 ± 11, p = 0.006). Our findings highlight the need to further investigate these findings in other populations and develop sex specific timelines for Alzheimer's disease progression.
Objectives:
This study aimed to identify the factors affecting the cognitive function of elderly people in a community by gender.
Methods:
4,878 of secondary data of people aged ≥65 years in 2016 at a dementia prevention center in Geyangu in Incheon. Data were obtained through MMSE-DS and a questionnaire. The data were statistically analyzed using analysis of variance, analysis of covariance, and hierarchical regression.
Results:
There were significant differences in cognitive function according to sex, and the differences were significant even when age was controlled, but gender differences disappeared when education was controlled. Age, education, social activities, number of diseases, and alcohol consumption affected cognitive function through interaction with gender, but interaction with gender disappeared when education was controlled. Regression analysis showed that depression, cohabitant, social activities etc., had a significant impact on both men and women under controlled education and age. In men, the effect of social activities was greater than that of women, and only hyperlipidemia had the effect in women.
Conclusion:
The differences in gender-related cognitive functions were due to differences in gender education levels. The level of education is considered to have a great influence on cognitive function in relation to the economic level, occupation, and social activity.
Purpose
COPD is associated with cognitive impairment. These impairments should be diagnosed, but due to time- and budget-reasons, they are often not investigated. The aim of this study is to examine the viability of a brief computerized cognitive test battery, Central Nervous System Vital Signs (CNSVS), in COPD patients.
Patients and methods
Patients with COPD referred to tertiary pulmonary rehabilitation were included. Cognitive functioning of patients was assessed with CNSVS before pulmonary rehabilitation and compared with age-corrected CNSVS norms. CNSVS is a 30 minute computerized test battery that includes tests of verbal and visual memory, psychomotor speed, processing speed, cognitive flexibility, complex attention, executive functioning, and reaction time.
Results
CNSVS was fully completed by 205 (93.2%, 105 females, 100 males) of the total group of patients (n=220, 116 females, 104 males). Z-tests showed that COPD patients performed significantly worse than the norms on all CNSVS cognitive domains. Slightly more than half of the patients (51.8%) had impaired functioning on 1 or more cognitive domains. Patients without computer experience performed significantly worse on CNSVS than patients using the computer frequently.
Conclusion
The completion rate of CNSVS was high and cognitive dysfunctions measured with this screening were similar to the results found in prior research, including paper and pen cognitive tests. These results support the viability of this brief computerized cognitive screening in COPD patients, that may lead to better care for these patients. Cognitive performance of patients with little computer experience should be interpreted carefully. Future research on this issue is needed.
Background
Dementia is a growing concern for low- and middle-income countries where longevity is increasing and service provision is poor. Global prevalence estimates vary from 2% to 8.5% for those aged 60 years and older. There have been few dementia studies in sub-Saharan Africa, and prevalence data are lacking for South Africa.
Objective
To conduct a large dementia prevalence study in a low income rural population in South Africa.
Methods
1,394 Xhosa-speaking community dwellers, aged ≥60 y (mean age±sd 71.3±8.3 y), in three clinic catchment areas, were screened at home. Trained community health workers administered the brief Community Screening Instrument for Dementia (CSID) to participants and informants to assess cognitive and functional capacity. Depressive symptoms were assessed with three questions from the EURO-D.
Results
The prevalence estimate using published CSID sensitivity/specificity values was 0.8 (95% CI: 0.06–0.09). Using CSID cut-off scores the estimated prevalence was 0.12 (95% CI: 0.10–0.13), with 161 screen-positives. Both methods gave a rate of 0.11 (95% CI: 0.09–0.13) for those over 65 years (n = 1051). 68.6% of participants were female and 69.8% had less than 7 years of education. Dementia risk was associated with older age and symptoms of depression, but not with sex. The association with education was not significant when controlled for by age.
Conclusions
Dementia prevalence estimates were higher than expected for this low-income rural community. There is a need for increased dementia awareness and feasible support interventions. We also need further studies of regional prevalences, dementia subtypes, and modifiable risk factors in South Africa.
Introduction
HIV-associated neurocognitive disorder (HAND) is a consequence of HIV infection of the central nervous system. The prevalence ranges between 15% and 60% in different settings.
Objectives
This prospective study determined the prevalence of HAND at a peri-urban HIV clinic in KwaZulu-Natal. Factors associated with HAND were examined, alternate neurocognitive tools were tested against the international HIV dementia scale (IHDS) score and an association between HAND and non-adherence to antiretroviral therapy (ART) was explored.
Methods
Between May 2014 and May 2015, 146 ART-naïve outpatients were assessed for HAND. IHDS score ≤ 10 established a diagnosis of HAND. Functional capacity was assessed using Eastern Cooperative Oncology Group (ECOG) score. Chi-squared test was used to identify risk factors for HAND. The get-up-and-go test (GUGT) and Center for Epidemiological Studies Depression scale – revised (CESD-r) were tested against the IHDS. HIV viral load done six months after initiating ART was used as a surrogate marker for adherence to ART.
Results
The prevalence of HAND was 53%. In total, 99.9% of patients with HAND had no functional impairment. Age > 50 years old was associated with HAND (p = 0.003). There was no correlation between the GUGT, CESD-r and the IHDS score. HAND was not associated with non-adherence (p = 0.06).
Conclusions
While the prevalence of HAND is high, it is not associated with functional impairment which suggests that asymptomatic neurocognitive impairment is prevalent. Age > 50 years old is a risk factor for HAND. The GUGT and CESD-r are not useful diagnostic tools for HAND. The relationship between HAND and non-adherence should be further explored.
Introduction:
Central Nervous System Vital Signs (CNS VS) is a computerized neuropsychological battery that is translated into many languages. However, published CNS VS' normative data were established over a decade ago, are solely age-corrected, and collected in an American population only.
Method:
Mean performance of healthy Dutch participants on CNS VS was compared with the original CNS VS norms ( N = 1,069), and effects of sociodemographic variables were examined.
Results:
z tests demonstrated no significant differences in performance on four out of seven cognitive domains; however, Dutch participants ( N = 158) showed higher scores on processing and psychomotor speed, as well as on cognitive flexibility. Although the original CNS VS norms are solely age-corrected, effects of education and sex on CNS VS performance were also identified in the Dutch sample.
Discussion:
Users should be cautious when interpreting CNS VS performance based on the original American norms, and sociodemographic factors must also be considered.
Education is one of the strongest predictors of health worldwide. In South Africa, school dropout is a crisis where by Grade 12, only 52% of the age appropriate population remain enrolled. Survival analysis was used to identify the risk of dropping out of secondary school for male and female adolescents and examine the influence of substance use and leisure experience predictors while controlling for demographic and known predictors using secondary, longitudinal data. Results indicated being male, not living with one’s mother, smoking cigarettes in the past month, and lower levels of leisure-related intrinsic motivation significantly predicted dropout. Results support comprehensive prevention programmes that target risk behaviour and leisure. © 2017, South African Journal Of Education. All rights reserved.
p> Objective. To investigate cognitive functioning and associated factors in a national probability sample of older South Africans who participated in the Study of Global AGEing and Adult Health (SAGE) in 2008.
Methods. In 2008 we conducted a national population-based cross-sectional study with a sample of 3 840 adults aged ≥50 years in South Africa. We administered a questionnaire surveying socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements. Multivariate regression analyses were used to assess the association of socio-demographic factors and health variables with cognitive functioning.
Results. Mean variables in the sample were: 5.9 recalled words, a verbal fluency of 9.9 words in a specified category (animals), a forward and backward digit span of 5.2 and 3.2, respectively, and an overall mean cognition score of 48.5. Higher overall cognitive functioning (a combination of memory and executive functioning) was positively associated with: younger age; white, Indian/Asian or coloured ethnicity; being married; a higher level of education; greater wealth; a higher level of physical activity; a greater quality of life; and a better subjective health status.
Conclusions. Our findings can be used to refine future projections of cognitive function and healthcare needs in ageing middle-income societies such as those in South Africa.</p
Introduction
There is a growing proportion of population aged 65 years and older in low-income and middle-income countries. In Malaysia, this proportion is predicted to increase from 5.1% in 2010 to more than 15.4% by 2050. Cognitive ageing and dementia are global health priorities. However, risk factors and disease associations in a multiethnic, middle-income country like Malaysia may not be consistent with those reported in other world regions. Knowing the burden of cognitive impairment and its risk factors in Malaysia is necessary for the development of management strategies and would provide valuable information for other transitional economies.
Methods and analysis
This is a community-based feasibility study focused on the assessment of cognition, embedded in the longitudinal study of health and demographic surveillance site of the South East Asia Community Observatory (SEACO), in Malaysia. In total, 200 adults aged ≥50 years are selected for an in-depth health and cognitive assessment including the Mini Mental State Examination, the Montreal Cognitive Assessment, blood pressure, anthropometry, gait speed, hand grip strength, Depression Anxiety Stress Score and dried blood spots.
Discussion and conclusions
The results will inform the feasibility, response rates and operational challenges for establishing an ageing study focused on cognitive function in similar middle-income country settings. Knowing the burden of cognitive impairment and dementia and risk factors for disease will inform local health priorities and management, and place these within the context of increasing life expectancy.
Ethics and dissemination
The study protocol is approved by the Monash University Human Research Ethics Committee. Informed consent is obtained from all the participants. The project's analysed data and findings will be made available through publications and conference presentations and a data sharing archive. Reports on key findings will be made available as community briefs on the SEACO website.
Background
Populations worldwide are aging. Cognitive decline is an important precursor of dementia, illness and death and, even within the normal range, is associated with poorer performance on everyday tasks. However, the impact of age on cognitive function does not always receive the attention it deserves.
Methods
We have explored cross-sectional associations of age with five cognitive tests (word recall, verbal fluency, subtraction, number sequence, and numerical problem solving) in a large representative sample of over 40,000 men and women aged 16 to 100 living in the UK.
Results
Women performed better on word recall tests and men had higher scores for subtraction, number sequence and numerical problem solving. However, age-cognition associations were generally similar in both genders. Mean word recall and number sequence scores decreased from early adulthood with steeper declines from the mid-60s onwards Verbal fluency, subtraction and numerical problem solving scores remained stable or increased from early to mid-adulthood, followed by approximately linear declines from around age 60. Performance on all tests was progressively lower in respondents with increasingly worse self-rated health and memory. Age-related declines in word recall, verbal fluency and number sequence started earlier in those with the worst self-rated health. There was no compelling evidence for age dedifferentiation (that the general factor of cognitive ability changes in strength with age).
Conclusions
We have confirmed previously observed patterns of cognitive aging using a large representative population sample.
Introduction:
This study examined whether, among subjects with mild cognitive impairment (MCI), women progressed at faster rates than men.
Methods:
We examine longitudinal rates of change from baseline in 398 MCI subjects (141 Females, 257 Males) in the Alzheimer's Disease Neuroimaging Initiative-1 (ADNI-1), followed for up to 8 years (mean 4.1±2.5 years) using mixed effects models incorporating all follow ups (mean 8±4 visits).
Results:
Women progressed at faster rates than men on ADAS-Cog (p=0.001) and CDR-SB (p=0.003). Quadratic fit for change over time was significant for both ADAS-Cog (p=0.001) and CDR-SB (p=0.004), and the additional acceleration in women was 100% for ADAS-Cog and 143% for CDR-SB. The variability of change was greater in women. The gender effect was greater in ApoE4 carriers.
Discussion:
Women with MCI have greater longitudinal rates of cognitive and functional progression than men. Studies to confirm and uncover potential mechanisms appear to be warranted.
Dementia is one of the biggest challenges to society today, with an increasing prevalence as the global population ages. The 2013 worldwide estimate was 44 million persons with dementia, with predictions that about 70% of new cases will occur in low- and middle-income countries (LMICs). With negligible published prevalence data for South Africa, little is known about the impact of dementia, especially in poorer communities. Successful community dementia prevalence screening has been conducted in ten LMICs worldwide, using a one-step diagnostic procedure developed in the UK by the 10/66 group. The prevalence of dementia needs to be established locally across various communities. Awareness, education, training and skilled resources for diagnosis and care are minimal. Only once prevalence data and an assessment of care needs are available will it be possible to propose improving health services for the growing aged population, especially those with dementia in poorer rural communities. © 2015, South African Medical Association. All Rights Reserved.
Objective:
We examined the influence of a broad spectrum of life experiences on longitudinal cognitive trajectories in a demographically diverse sample of older adults.
Method:
Participants were 333 educationally, ethnically, and cognitively diverse older adults enrolled in a longitudinal aging study. Mixed-effects regression was used to measure baseline status in episodic memory, executive functioning, and semantic memory and change in a global cognition factor defined by change in these 3 domain-specific measures. We examined effects of life experience variables (literacy, childhood socioeconomic status, morphometric measures of physical development, life course physical and recreational activity) on longitudinal cognitive trajectories, covarying for age, apolipoprotein E (APOE) genotype and demographics (education, ethnicity, language).
Results:
Non-Latino Whites had higher baseline cognition, but life experience variables attenuated ethnic differences in cognitive scores. Age, literacy, childhood socioeconomic status, and physical activity significantly influenced baseline cognition. Age, APOE ε4, and decline in intellectually and socially stimulating recreational activity from mid to late life were independently associated with increased late life cognitive decline. Higher literacy and late life recreational activity were associated with less decline. Literacy had similar effects for English and Spanish readers/speakers. Bilingual English and Spanish speakers did not differ from English Speakers in cognitive performance.
Conclusions:
Life experience variables, especially literacy level, were strongly related to baseline cognition and substantially attenuated effects of race/ethnicity and education. Cognitive change was best explained by age, APOE ε4, literacy, and current recreational activities. Literacy had robust associations with baseline cognition and cognitive change in both English and Spanish speakers.
Background and objective
Unhealthy lifestyle behaviours are important risk factors of morbidity and mortality. This study aimed to explore the sociodemographic predictors of multiple non-communicable disease (NCD) risk factors experienced by elderly South Africans.
Methods
We conducted a national population-based cross-sectional survey with a sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The outcome variable was the co-existence of multiple NCD risk factors (tobacco use, alcohol, physical inactivity, fruit and vegetable intake, overweight or obesity, and hypertension) in each individual. The exposure variables were sociodemographic characteristics, namely, age, gender, education, wealth status, population group, marital status, and residence. Multivariate linear regression was used to assess the association between sociodemographic variables and multiple NCD risk factors.
Results
The mean number of NCD risk factors among all participants was three (95% confidence interval: 2.81–3.10). Multivariate linear regression analysis revealed that being female, being in the age group of 60–69 years, and being from the Coloured and Black African race were associated with a higher number of NCD risk factors. Marital status, educational level, wealth, and residence were not significantly associated with the number of NCD risk factors experienced.
Conclusions
The co-existence of multiple lifestyle NCD risk factors among the elderly is a public health concern. Comprehensive health-promotion interventions addressing the co-existence of multiple NCD risk factors tailored for specific sociodemographic groups are needed.
The purpose of this study was to evaluate how demographic variables relate to cognitive change and address whether cross-sectional demographic effects on cognitive tests are mirrored in differences in longitudinal trajectories of cognitive decline. We hypothesized that race and ethnicity, education, and language of test administration would relate to cross-sectional status and that the rate of cognitive decline would differ among African Americans, Hispanics, and Caucasians, across levels of educational attainment, and according to linguistic background. Participants were 404 educationally, ethnically, and cognitively diverse older adults enrolled in an ongoing longitudinal study of cognition. Mixed-effects regression analysis was used to measure baseline status and longitudinal change in episodic memory, executive functioning, and semantic memory. Results showed that ethnicity and education were strongly associated with baseline scores, but were, at most, weakly associated with change in cognition over time after accounting for confounding variables. There was evidence that the episodic-memory scores of Spanish-speaking Hispanic participants with limited education underestimated their true abilities in the initial evaluation, which may reflect lack of familiarity with the testing environment. These results-consistent with other reports in the literature-suggest that cross-sectional effects of demographic variables on cognitive-test scores result from differences in life experiences that directly influence test performance and do not indicate greater disease effects on cognition in minorities and those with limited education. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
This review was aimed at systematically in-vestigating the evidence suggesting that obese individ-uals demonstrate impaired performance on behavioural tasks examining executive functioning abilities. A sys-tematic review of literature was carried out by search-ing five separate databases (PsycINFO, MEDLINE, EMBASE, CINAHL and PubMed) and a hand search of relevant journals. Twenty-one empirical papers were identified from the search criteria and the results were considered in relation to different executive functioning domains. There is little consistency of results both within and across different domains of executive func-tioning. The review suggests that obese individuals show difficulties with decision-making, planning and problem-solving when compared to healthy weight con-trols, with fewer difficulties reported on tasks examin-ing verbal fluency and learning and memory. A lack of replication and underreporting of descriptive data is a key limitation of studies in this area and further re-search is needed to examine the mechanisms underpin-ning the relationship between obesity and executive functioning.
Objective:
The coloured population has the second-highest prevalence of diabetes in South Africa. However, the data were based on a study conducted almost 20 years ago in a peri-urban coloured population of the Western Cape. We aimed to determine the prevalence of diabetes mellitus and metabolic syndrome in an urban coloured population in South Africa.
Design:
In a cross-sectional survey, 642 participants aged ≥31 years were drawn from an urban community of Bellville South, Cape Town, from mid-January 2008 to March 2009. Type 2 diabetes was assessed according to the WHO criteria, and metabolic syndrome was based on the International Diabetes Federation (IDF), ATP III and 2009 Joint Interim Statement (JIS) definition.
Results:
The crude prevalence of 28.2% (age-adjusted 26.3%, 95% confidence interval (CI) 22.0 - 30.3) for type 2 diabetes was: 4.4% (age-adjusted 3.2%, 95% CI 1.6 - 4.9) for impaired fasting glycaemia, and 15.3% (age-adjusted 15.0%, 95% CI 11.4 - 18.6) for impaired glucose tolerance. Undiagnosed type 2 diabetes was present in 18.1% (age-adjusted 16.8%, 95% CI 13.3 - 20.4). The crude prevalence of metabolic syndrome was higher with the JIS definition (62.0%) than the IDF (60.6%), and the National Cholesterol Education Program (NCEP) ATP III (55.4%). There was good overall agreement between the MetS criteria, k=0.89 (95% CI 0.85 - 0.92).
Conclusion:
The prevalence of diabetes has increased hugely in the coloured community, and the high prevalence of undiagnosed diabetes portends that cardiovascular diseases might grow to epidemic proportions in the near future in South Africa.
Background:
Cognitive reserve (CR) or brain reserve capacity explains why individuals with higher IQ, education, or occupational attainment have lower risks of developing dementia, Alzheimer's disease (AD) or vascular dementia (VaD). The CR hypothesis postulates that CR reduces the prevalence and incidence of AD or VaD. It also hypothesizes that among those who have greater initial cognitive reserve (in contrast to those with less reserve) greater brain pathology occurs before the clinical symptoms of disease becomes manifest. Thus clinical disease onset triggers a faster decline in cognition and function, and increased mortality among those with initial greater cognitive reserve. Disease progression follows distinctly separate pathological and clinical paths. With education as a proxy we use meta-analyses and qualitative analyses to review the evidence for the CR hypothesis.
Methodology/principal findings:
We searched PubMed, PsycoINFO, EMBASE, HealthStar, and Scopus databases from January 1980 to June 2011 for observational studies with clear criteria for dementia, AD or VaD and education. One hundred and thirty-three articles with a variety of study designs met the inclusion criteria. Prevalence and incidence studies with odds ratios (ORs), relative risks or original data were included in the meta-analyses. Other studies were reviewed qualitatively. The studies covered 437,477 subjects. Prevalence and incidence studies with pooled ORs of 2.61 (95%CI 2.21-3.07) and 1.88 (95%CI 1.51-2.34) respectively, showed low education increased the risk of dementia. Heterogeneity and sensitivity tests confirmed the evidence. Generally, study characteristics had no effect on conclusions. Qualitative analyses also showed the protective effects of higher education on developing dementia and with clinical disease onset hastening a decline in cognition and function, and greater brain pathology.
Conclusion/significance:
This systematic review and meta-analyses covering a wide range of observational studies and diverse settings provides robust support for the CR hypothesis. The CR hypothesis suggests several avenues for dementia prevention.
To examine the respective associations between indices of aerobic fitness, metabolic control and locomotor function and repeated sprint-performance, 61 team sport players performed: a repeated-sprint sequence (RSS), an incremental test to exhaustion to determine maximal oxygen uptake (V˙O2max) and peak incremental test speed (Inc. test speed), and 2-4 submaximal runs to determine the time constant of the primary phase of V˙O2 kinetics at exercise onset (V˙O2τon) and cessation (V˙O2τoff). The best (RSbest) sprint times and mean sprint times (RSmean) and the percent sprint decrement (%Dec) were calculated. RSmean was almost perfectly correlated with RSbest (r=0.92;90%CL(0.88;0.95)), largely correlated with Inc. test speed (r=-0.71;90%CL(- 0.79; - 0.59)) and moderately correlated with V˙O2max (r= - 0.58;90%CL(- 0.70; - 0.43)); the correlations with V˙O2τon or V˙O2τoff were unclear. For%Dec, the correlations with Inc. test speed, V˙O2max and V˙O2τon were moderate (r=- 0.41;90%CL(- 0.56; - 0.23)), small (r=- 0.26;90%CL(- 0.43; - 0.06)) and small (r=0.28;90%CL(0.09;0.46)), respectively. Stepwise multiple regression analyses showed that the only significant predictors of RSmean were RSbest and Inc. test speed (r 2=0.88). Inc. test speed and RSbest were also the only significant predictors of %Dec (r 2=0.26). Present results obtained in a large sample of team sport players highlight that locomotor factors (i. e., RSbest and Inc. test speed) show much larger associations with repeated-sprint performance than V˙O2max and V˙O2 kinetics.
There is an urgent need for valid, reliable, and simple-to-use screening tools for HIV-associated dementia (HAD) in South Africa, as little is known about its impact on South Africa's 5.5 million people living with HIV (PLWH). Screening for HAD in South Africa involves several challenges, including few culturally appropriate and validated screening tools, and a shortage of trained personnel to conduct screening. This study examined rates of positive HAD screens as determined by the cutoff score on the International HIV Dementia Scale (IHDS) administered by nonspecialist community health workers (CHWs) in South Africa and examined associations between positive HAD screens and common risk factors for HAD. Sixty-five Xhosa-speaking HIV-positive individuals on antiretroviral therapy (ART) with low CD4 counts and documented ART adherence problems were administered a battery of demographic, psychiatric and neurocognitive screening measures. Positive HAD screens were present in 80% of the sample. Presence of a current alcohol dependence disorder and CD4 counts of 200 or lower were significantly associated with positive HAD screens. HIV-positive South Africans on ART with low CD4 counts and ART adherence problems may be at a very high risk for HAD, highlighting the need for more routine screening and monitoring of neurocognitive functions among South Africa's millions of PLWH on ART. Future research is needed to: (1) validate IHDS performance against a gold standard neurocognitive battery for the detection of HAD among larger samples of Xhosa-speaking South Africans with ART adherence difficulties and (2) compare performance of CHW to expert health care personnel in administering the IHDS.
Research concerned with relations between adult age and cognitive functioning is briefly reviewed. The coverage is necessarily selective, and is organized in terms of five major questions. These are what abilities are related to age, how many distinct influences are contributing to the relations between age and cognitive functioning, do the differences between people increase with advancing age, what is responsible for the discrepancies between cross-sectional and longitudinal age comparisons of cognitive functioning, and what methods can be used to identify causes of age-related influences on cognition. Although definitive answers are not yet possible, quite a bit of information relevant to the questions is now available. Moreover, the existing information has implications for the design, analysis, and interpretation of cognitive and neuropsychological research concerned with aging.
To examine the prevalence of cognitive impairment in a Spanish elderly population and to analyse its association with some social and medical factors.
We randomly selected a representative sample (n = 600) of people over 65 from Narón Council (A Coruña). Socio-demographic and biomedical data were collected and cognitive status was assessed using the Mini-Mental State Examination (MMSE).
We determined variations in the prevalence from 35.2%, when age or level of education distribution was not applied, to 22.2% when they were applied. Women showed a higher probability of cognitive impairment than men. Negative correlation was observed between the age of the subject and the MMSE score (Spearman correlation rho = -0.45, p < 0.001), with the possibility of developing cognitive impairment increasing each year. For our sample, cognitive impairment was associated with an increase of morbidity and mortality in the elderly population. This association was found with the presence of dementia, heart failure, anaemia, stroke and auditory deficits.
Knowledge of the real prevalence rates, together with the establishment of adequate preventive and intervention measures, can be factors that may diminish the socio-sanitary impact of cognitive impairment.
Although education is consistently related to better cognitive performance, findings on the relationship between education and age-associated cognitive change have been conflicting. Using measures of multiple cognitive domains from four waves of the Asset and Health Dynamics of the Oldest Old study, a representative sample of Americans aged 70 years and older, the authors performed growth curve modeling to examine the relationships between education, initial cognitive score, and the rate of decline in cognitive function. More years of education were linked to better initial performance on each of the cognitive tests, and higher levels of education were linked to slower decline in mental status. However, more education was unrelated to the rate of decline in working memory, and education was associated with somewhat faster cognitive decline on measures of verbal memory. These findings highlight the role of early-life experiences not only in long-term cognitive performance but also in old-age cognitive trajectories.
A descriptive non-experimental approach was applied to investigate and describe the prevalence of factors influencing the health status of the Coloured people of the Western Cape in an urban setting as a dissertation for a doctorate degree. For the purpose of this article the relationship between the socio-economic and health status of the Coloured people of the Western Cape in an urban setting are described. The study only included economically active persons < 21 < or = 50 years. The objective was to determine the relationship between the health status and the socio-economic status of economically active Coloured people in an urban area as defined. The objectives set for the study were reached through a cross sectional study. The hypothesis, an association between the health status and the socio-economic status of the Coloured people of an urban area in the Western Cape was tested using the chi square statistical test. A purposeful stratified sample of 353 participants was drawn from the residential areas as defined for the purpose of the study. All social classes were well represented in the suburbs. Statistical associations on a 95% confidence interval were shown between the socio-economic status (i.e. educational level, income and occupation) social habits, diet, and money available for food, exercise and the health status of the respondents. Recommendations were made based on the scientific evidence obtained through the study.
As we grow older, we may grow wiser, but we can also experience memory loss and cognitive slowing that can interfere with our daily routines. The cognitive neuroscience of human ageing, which relies largely on neuroimaging techniques, relates these cognitive changes to their neural substrates, including structural and functional changes in the prefrontal cortex, medial temporal lobe regions and white matter tracts. Much remains unknown about how normal ageing affects the neural basis of cognition, but recent research on individual differences in the trajectory of ageing effects is helping to distinguish normal from pathological origins of age-related cognitive changes.
Cognitive decline in speeded abilities, executive function, and memory is believed to typify normal aging. However, there is significant variability in cognitive function with advanced age and some reports of relatively intact cognitive function among a subset of older individuals. The present study consists of a cluster analysis to examine the patterns of cognitive function in middle-aged and older individuals. Analyses revealed 3 clusters of middle-aged adults, including an intact group, persons with poor motor speed, and a group with reduced executive function. Three clusters were also identified for older adults, including a group with poor executive function, persons with reduced speed performance (attention, executive function, motor), and a group with global cognitive decline. No evidence emerged for a cluster of older adults with intact performance in all domains or with isolated memory deficits. Findings generally support the frontal aging hypothesis and may provide important information about healthy cognitive aging.
CNS Vital Signs (CNSVS) is a computerized neurocognitive test battery that was developed as a routine clinical screening instrument. It is comprised of seven tests: verbal and visual memory, finger tapping, symbol digit coding, the Stroop Test, a test of shifting attention and the continuous performance test. Because CNSVS is a battery of well-known neuropsychological tests, one should expect its psychometric properties to resemble those of the conventional tests upon which it is based.
1069 subjects age 7–90 participated in the normative database for CNSVS. Test-retest reliability (TRT) was evaluated in 99 Ss who took the battery on two separate occasions, separated, on the average, by 62 days; the results were comparable to those achieved by equivalent conventional and computerized tests. Concurrent validity studies in 180 subjects, normals and neuropsychiatric patients, indicate correlations that are comparable to the concurrent validity of similar tests. Discriminant validity is supported by studies of patients with mild cognitive impairment and dementia, post-concussion syndrome and severe traumatic brain injury, ADHD (treated and untreated) and depression (treated and untreated). The tests in CNSVS are also sensitive to malingerers and patients with conversion disorders.
The psychometric characteristics of the tests in the CNSVS battery are very similar to the characteristics of the conventional neuropsychological tests upon which they are based. CNSVS is suitable for use as a screening instrument, or as a serial assessment measure. But it is not a substitute for formal neuropsychological testing, it is not diagnostic, and it will have only a limited role in the medical setting, absent the active participation of consulting neuropsychologists.
Objectives: 1. Assess validity of the Oxford Cognitive Screen (OCS-Plus), a domain-specific cognitive assessment designed for low-literacy settings, especially in low- and middle-income countries (LMIC); 2. Advance theoretical contributions in cognitive neuroscience in domain-specific cognitive function and cognitive reserve, especially related to dementia.
Method: In a cross-sectional study of a sample of 1,402 men and women aged 40–79 in the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we administered OCS-Plus along with health and sociodemographic assessments. HAALSI is a representative sample of older adults in Agincourt, South Africa contributing to normative understanding of cognition in LMIC. We report measure distributions, construct and external validity of the OCS-Plus.
Results: OCS-Plus has excellent construct and external validity. Intra-class correlations between similar basic measures of orientation in OCS-Plus and in HAALSI assessments was 0.79, and groups of people performing well on the OCS-Plus verbal memory also showed superior performance on HAALSI verbal memory. The OCS-Plus scores showed consistent associations with age and education and domain-specific associations with alcohol and depression. Younger respondents and the more educated did better on all assessments.
Discussion: The OCS-Plus represents a major methodological advance in dementia studies in LMICs, and enhances understanding of cognitive aging.
Background:
Clinical cognitive impairment and physical frailty often co-occur. However, it is unclear whether preclinical impairment or decline in cognitive domains are associated with onset of physical frailty. We tested this hypothesis and further hypothesized that preclinical impairment and decline in executive functioning are more strongly associated with frailty onset than memory or general cognitive performance.
Methods:
We used 9 years of data from the Women's Health and Aging Study II (six visits) that longitudinally measured psychomotor speed and executive functioning using the Trail Making Test, parts A and B, respectively, and immediate and delayed word-list recall from the Hopkins Verbal Learning Test. We used Cox proportional hazards models to regress time to frailty on indicators for impairment on these cognitive tests and on rates of change of the tests. Models adjusted for depressive symptoms, age, years of education, and race.
Results:
Of the 331 women initially free of dementia and frailty, 44 (13%) developed frailty. A binary indicator of impaired executive functioning (Trail Making Test, part B [TMT-B]) was most strongly associated with hazard, or risk, of frailty onset (hazard ratio [HR] = 3.3, 95% confidence interval [CI] = 1.4, 7.6) after adjustment for covariates and other tests. Adjusting for baseline cognitive performance, faster deterioration on TMT-B (HR = 0.6, 95% CI = 0.4, 1.0) was additionally associated with hazard of frailty onset.
Conclusions:
Findings inform the association of executive functioning with transitions to frailty, suggesting both impairments in and declines in executive functioning are associated with risk of frailty onset. It remains to be determined whether these associations are causal or whether shared aging related or other mechanisms are involved.
This article reviews the cognitive changes that occur with normal aging, the structural and functional correlates of these cognitive changes, and the prevalence and cognitive effects of age-associated diseases. Understanding these age-related changes in cognition is important given our growing elderly population and the importance of cognition in maintaining functional independence and effective communication with others. The most important changes in cognition with normal aging are declines in performance on cognitive tasks that require one to quickly process or transform information to make a decision, including measures of speed of processing, working memory, and executive cognitive function. Cumulative knowledge and experiential skills are well maintained into advanced age. Structural and function changes in the brain correlate with these age-related cognitive changes, including alterations in neuronal structure without neuronal death, loss of synapses, and dysfunction of neuronal networks. Age-related diseases accelerate the rate of neuronal dysfunction, neuronal loss, and cognitive decline, with many persons developing cognitive impairments severe enough to impair their everyday functional abilities. There is emerging evidence that healthy lifestyles may decrease the rate of cognitive decline seen with aging and help delay the onset of cognitive symptoms in the setting of age-associated diseases.
Although racial segregation has been abolished for 18 years now, schools which served predominantly White students under apartheid remain functional, while those which served Black students remain dysfunctional and unable to impart the necessary numeracy and literacy skills students should be acquiring by this level. The present study provides an overview of this dualistic nature of the primary education system in South Africa, with special attention paid to the bimodality of student performance. It argues that there are in fact two different education systems in South Africa and thus two different data-generating processes. These two sub-systems can be seen when splitting student performance by former-department, language, or socioeconomic status. The implications of such a dualistic schooling system are also elucidated, with special emphasis on government reporting and econometric modeling. The recently released SACMEQ III dataset is used for the econometric modeling. The study finds that when modeling student performance separately for the wealthiest 25% of schools on the one hand, and the poorest 75% of schools on the other, there are stark differences in the factors influencing student performance which are large and statistically significant. Only 5 of the 27 factors are shared between the two models for mathematics, and 11 of the 29 factors for reading. This suggests a bifurcated system where the process which converts inputs into outputs is fundamentally different for each sub-system. Ultimately the paper has two logical conclusions: 1) Observing averages in South African education is uniquely misleading and overestimates the educational achievement of the majority of students, and 2) Modeling a single schooling system when there are in fact two school systems can lead to spurious results and misleading policy conclusions.
The concept of cognitive reserve provides an explanation for differences between individuals in susceptibility to age-related brain changes or pathology related to Alzheimer's disease, whereby some people can tolerate more of these changes than others and maintain function. Epidemiological studies suggest that lifelong experiences, including educational and occupational attainment, and leisure activities in later life, can increase this reserve. For example, the risk of developing Alzheimer's disease is reduced in individuals with higher educational or occupational attainment. Reserve can conveniently be divided into two types: brain reserve, which refers to differences in the brain structure that may increase tolerance to pathology, and cognitive reserve, which refers to differences between individuals in how tasks are performed that might enable some people to be more resilient to brain changes than others. Greater understanding of the concept of cognitive reserve could lead to interventions to slow cognitive ageing or reduce the risk of dementia.
Although the relationship between education and cognitive status is well-known, evidence regarding whether education moderates the trajectory of cognitive change in late life is conflicting. Early studies suggested that higher levels of education attenuate cognitive decline. More recent studies using improved longitudinal methods have not found that education moderates decline. Fewer studies have explored whether education exerts different effects on longitudinal changes within different cognitive domains. In the present study, we analyzed data from 1014 participants in the Victoria Longitudinal Study to examine the effects of education on composite scores reflecting verbal processing speed, working memory, verbal fluency, and verbal episodic memory. Using linear growth models adjusted for age at enrollment (range, 54-95 years) and gender, we found that years of education (range, 6-20 years) was strongly related to cognitive level in all domains, particularly verbal fluency. However, education was not related to rates of change over time for any cognitive domain. Results were similar in individuals older or younger than 70 at baseline, and when education was dichotomized to reflect high or low attainment. In this large longitudinal cohort, education was related to cognitive performance but unrelated to cognitive decline, supporting the hypothesis of passive cognitive reserve with aging.
Human immunodeficiency virus-associated neurocognitive disorders (HAND) occurs globally and across different genetic clades of the virus. However, few studies have examined HAND in South Africa, despite the prevalence of HIV in this region of the world, and the predominance of clade C. The present study examined the relationship between a number of demographic and clinical variables in a sample of 536 patients attending HIV clinics in South Africa. HAND was present in 23.5% of the sample and was associated with older age, a low educational level among those with post-traumatic stress disorder (PTSD) and alcohol abuse among those with many months since diagnosis. These results suggest that HAND is common among patients in South Africa, and is associated with clinical variables such as PTSD and alcohol abuse. This underlines the impact of HIV on the nervous system and the importance of screening for co morbid mental health conditions.
Cross-sectional comparisons have consistently revealed that increased age is associated with lower levels of cognitive performance, even in the range from 18 to 60 years of age. However, the validity of cross-sectional comparisons of cognitive functioning in young and middle-aged adults has been questioned because of the discrepant age trends found in longitudinal and cross-sectional analyses. The results of the current project suggest that a major factor contributing to the discrepancy is the masking of age-related declines in longitudinal comparisons by large positive effects associated with prior test experience. Results from three methods of estimating retest effects in this project, together with results from studies comparing non-human animals raised in constant environments and from studies examining neurobiological variables not susceptible to retest effects, converge on a conclusion that some aspects of age-related cognitive decline begin in healthy educated adults when they are in their 20s and 30s.
Statistical guidelines and expert statements are now available to assist in the analysis and reporting of studies in some biomedical disciplines. We present here a more progressive resource for sample-based studies, meta-analyses, and case studies in sports medicine and exercise science. We offer forthright advice on the following controversial or novel issues: using precision of estimation for inferences about population effects in preference to null-hypothesis testing, which is inadequate for assessing clinical or practical importance; justifying sample size via acceptable precision or confidence for clinical decisions rather than via adequate power for statistical significance; showing SD rather than SEM, to better communicate the magnitude of differences in means and nonuniformity of error; avoiding purely nonparametric analyses, which cannot provide inferences about magnitude and are unnecessary; using regression statistics in validity studies, in preference to the impractical and biased limits of agreement; making greater use of qualitative methods to enrich sample-based quantitative projects; and seeking ethics approval for public access to the depersonalized raw data of a study, to address the need for more scrutiny of research and better meta-analyses. Advice on less contentious issues includes the following: using covariates in linear models to adjust for confounders, to account for individual differences, and to identify potential mechanisms of an effect; using log transformation to deal with nonuniformity of effects and error; identifying and deleting outliers; presenting descriptive, effect, and inferential statistics in appropriate formats; and contending with bias arising from problems with sampling, assignment, blinding, measurement error, and researchers' prejudices. This article should advance the field by stimulating debate, promoting innovative approaches, and serving as a useful checklist for authors, reviewers, and editors.
Lower IQ is associated with earlier death, but the cause of the relationship is unknown. In the present study, psychometric intelligence and reaction times were both significantly related to all-cause mortality in a representative sample of 898 people aged 56 years who were followed up with respect to survival until age 70. The association between IQ and mortality remained significant after adjusting for education, occupational social class, and smoking, all of which have been hypothesized as confounding variables. The effect of IQ on mortality was not significant after adjusting for reaction time, suggesting that reduced efficiency of information processing might link lower mental ability and earlier death. This new field of cognitive epidemiology provides arguably the strongest evidence for the importance of psychological factors in physical health and human survival. Finding the mechanisms that relate psychometric intelligence to mortality might help in formulating effective interventions to reduce inequalities in health.
Mild cognitive impairment is a syndrome defined as cognitive decline greater than expected for an individual's age and education level but that does not interfere notably with activities of daily life. Prevalence in population-based epidemiological studies ranges from 3% to 19% in adults older than 65 years. Some people with mild cognitive impairment seem to remain stable or return to normal over time, but more than half progress to dementia within 5 years. Mild cognitive impairment can thus be regarded as a risk state for dementia, and its identification could lead to secondary prevention by controlling risk factors such as systolic hypertension. The amnestic subtype of mild cognitive impairment has a high risk of progression to Alzheimer's disease, and it could constitute a prodromal stage of this disorder. Other definitions and subtypes of mild cognitive impairment need to be studied as potential prodromes of Alzheimer's disease and other types of dementia.
The objective of this study was to determine a possible differential effect of age, education, and sex on cognitive speed, verbal memory, executive functioning, and verbal fluency in healthy older adults. A group of 578 healthy participants in the age range of 64-81 was recruited from a large population study of healthy adults (Maastricht Aging Study). Even in healthy individuals in this restricted age range, there is a clear, age-related decrease in performance on executive functioning, verbal fluency, verbal memory, and cognitive speed tasks. The capacity to inhibit information is affected most. Education had a substantial effect on cognitive functioning: participants with a middle or high level of education performed better on cognitive tests than did participants with a low level of education. Women performed better than men on verbal memory tasks. Therefore, education and sex must be taken into account when examining an older individual's cognitive performance.
Background:
There is a pressing need for brief behavioural interventions to address the intersection of high HIV prevalence, increasing substance use, and high-risk sex practices among South African women. The primary aim of this pilot, randomized trial was to examine whether an adapted evidence-based intervention would be equally, more, or less effective at reducing HIV risk behaviours when delivered using an individual or group format. The secondary aim was to examine differences between Black and Coloured South African women across pre- and post-intervention measures of alcohol and illicit drug use and sex risk behaviours.
Methods:
The Cape Town Women's Health CoOp was adapted from an evidence-based intervention known as the Women's CoOp. Study participants included Black (n=60) and Coloured (n=52) women living in the township communities of Cape Town, South Africa, who reported using illicit drugs and alcohol.
Results:
Coloured women reported greater methamphetamine use (13 days in the past 30 days) and Black women reported mostly cannabis use (27 days in the past 30 days). Although both groups reported having unprotected sex under the influence of alcohol and/or other drugs, Black women reported greater condom use and having one partner; Coloured women reported having more than one sex partner. One-month post-intervention assessments indicated significant reductions in substance use and sex risk behaviours. After controlling for baseline measures, there were no significant differences between the two intervention conditions.
Conclusion:
Significant differences in risk behaviours were observed between Black and Coloured South African women. However, both ethnic groups were responsive to the adapted intervention and no differences were found by intervention assignment. These findings support the assertion that group interventions may be more cost-effective in reaching at-risk women in resource-scarce environments. Larger studies are needed to show efficacy and effectiveness of woman-focused group prevention interventions.
Age-related decline: Detecting mild cognitive impairment (Doctoral Dissertation)
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Early roots of "coloured poverty": How much can 19th century censuses assist to explain the current situation
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High prevalence of diabetes mellitus and metabolic syndrome in a South African coloured population: Baseline data of a study in
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