Part of this work was supported by Plan Alzheimer Foundation on a Humanities and Social Sciences grant (AAP SHS 2013: &#34;Sociocognitive aspects of Alzheimer disease&#34; to F. Rigalleau and M. Mazerolle).

The present research was carried out in accordance with French standards, each participant provided informed consent and procedures were consistent with the guidelines of the American Psychological Association.
1. Highlighting and reducing age-based stereotype threat on a lab memory test
<ol>
	<li>Participants screening
	<ol>
		<li>Recruit participants in the desired age range (e.g., younger participants: 18&#8722;35 years old; older participants: 60&#8722;85 years old) for a study on general mental abilities and/or the impact of emotions on various cognitive tasks and questionnaires.</li>
		<li>Ensure that participants are native speakers, have normal or corrected-to-normal vision and hearing, are free of neurological and psychiatric disorders, and have no current depression (Geriatric Depression Scale17) nor abnormal anxiety (State-Trait Anxiety Inventory18).</li>
		<li>Screen older participants for cognitive impairment using the Mini-Mental State Examination (MMSE)19. Include older adults who meet or exceed a cutoff score corresponding to his/her age and educational level20, and who live at home.</li>
	</ol>
	</li>
	<li>Conditions and experimental design
	<ol>
		<li>Test each participant individually at home or in local community associations&#39; premises by an experimenter trained at neuropsychological testing.</li>
		<li>Run the study as a single session, but inform participants there are two separate studies.</li>
		<li>Use the &#34;first study&#34; as a baseline measure of participants&#39; working memory capacity. In the &#34;first study&#34;, minimize evaluative pressure, informing participants they will perform a cognitive task currently under elaboration. Encourage participants to do their very best21.</li>
		<li>Use the &#34;second study&#34; to evaluate the impact of stereotype threat on participants&#39; working memory capacity. That is, inform participants that they are going to perform a fully validated and diagnostic test of memory capacity.
		<ol>
			<li>Randomly assign participants to one of two conditions (threat versus reduced-threat conditions). 
			NOTE: See Figure 1 for a visual depiction of the procedure; full details on this research were published in Mazerolle et al.22.</li>
			<li>In the &#34;threat condition&#34;, simply tell participant that both younger and older adults are participating in the study.</li>
			<li>In the &#34;reduced threat condition&#34;, tell participants that both younger and older adults are participating in the study but add that younger and older adults usually obtain the same performances on the ongoing test.</li>
		</ol>
		</li>
	</ol>
	</li>
	<li>Memory tests and procedure
	<ol>
		<li>Use a validated memory test that is typically used in cognitive lab studies. Because ST effects typically occur on difficult tasks, use a difficult test, such as the reading span test23.</li>
		<li>Use two alternative versions of the reading span test (one for the &#34;first study&#34; and the other one for the &#34;second&#34; study), with different sentences but match them in number of words and in length, frequency, and number of syllables of the last word.</li>
		<li>Use a reading span test that contains 42 sentences: 12 series of two to five sentences with 3 series per length.</li>
		<li>Present one sentence at a time and instruct participant to read it, at his/her own pace, while memorizing the last word of the sentence.</li>
		<li>Ask participant not to interrupt his reading and not to pause between two sentences.</li>
		<li>Have participant to recall the words immediately after he/she finished reading the last sentence of the block considered.</li>
		<li>Do not require participants&#39; recall being serial but constrain them not to start by recalling the final word of the last sentence read. Do not limit the recall time and invite participants to find as many words as possible.</li>
		<li>Do not inform participants of their errors, and do not give them a second chance to answer.</li>
		<li>Compute the final score of each participant using the mean proportion of correctly recalled words across the 12 series.</li>
	</ol>
	</li>
</ol>
2. Highlighting and reducing age-based stereotype threat on short cognitive tests used to screen for predementia in clinical settings
<ol>
	<li>Participants screening
	<ol>
		<li>Recruit older participants aged 60 to 85 for a study on general mental abilities and/or the impact of emotions on various cognitive tasks and questionnaires.</li>
		<li>Ensure that participants live at home, have no history of significant trauma nor chronic illness, have normal or corrected-to-normal vision and hearing, have no current depression (Geriatric Depression Scale17) nor abnormal anxiety (State-Trait Anxiety Inventory18).</li>
	</ol>
	</li>
	<li>Conditions and experimental design
	<ol>
		<li>Test each participant individually at home or in local community associations&#39; premises by an experimenter trained at neuropsychological testing.</li>
		<li>Have participants taking two short cognitive tests used to screen for predementia (or mild cognitive impairment [MCI]): the MMSE19 and the Montreal Cognitive Assessment (MoCA24) in a counterbalanced order.</li>
		<li>Randomly assign participants to one of the two order (MMSE then MoCA or MoCA then MMSE).</li>
		<li>Before taking the first test, randomly assign participants to one of two threat conditions (threat versus reduced-threat conditions).</li>
		<li>In the &#34;threat condition&#34;, inform participants that both younger and older adults are taking part in the study about memory capacity.</li>
		<li>In the &#34;reduced threat condition&#34;, inform participants that both younger and older adults are taking part in the study about memory capacity but add that younger and older adults typically obtain the same performances on the ongoing tests.</li>
		<li>Before taking the second test, use an educational intervention to debrief all participants (regardless of the threat condition they were previously assigned) about age-based stereotype threat. Tell participants that &#34;Numerous studies demonstrated that negative age-related beliefs, especially about memory capacity decline, trigger anxiety, which in turn prevents older adults from performing optimally. Actually, it is well-known that performance on memory tests may not accurately reflect people&#39;s true abilities, because performance can be affected by the testing context. In other words, people&#39;s negative reputation in an ability domain may impair their performance on tests that assess this stereotyped ability, for example when older adults complete a memory test. Therefore, if you feel anxious during the subsequent memory test, this does not mean that you are unable to complete the tests. It rather probably means that your feelings are affected by the general negative reputation of older adults regarding memory.&#34; 
		NOTE: See Figure 2 for a visual depiction of the educational intervention; full details on this research were published in Mazerolle et al.25.</li>
	</ol>
	</li>
	<li>Short cognitive neuropsychological tests and procedure
	<ol>
		<li>Administrate the 8 subtests of the MMSE19 (orientation, registration, attention and calculation, recall, language, copying) to evaluate memory, orientation to time and place, attention and executive functioning, language and visuospatial abilities. Follow Folstein, Folstein and McHugh&#39;s administration guidelines19 and compute the final score adding the scores of every subtest. Obtain a final score rated on 30-point scale.</li>
		<li>Administrate the 8 subtests of the MoCA24 (visuospatial/executive, naming, memory, attention, language, abstraction, delayed recall, orientation) to evaluate memory, orientation to time and place, attention and executive functioning, language and visuospatial abilities. Follow administration guidelines available at <a href="http://www.mocatest.org/" target="_blank">www.mocatest.org</a> and compute the final score adding the scores of every subtest. Obtain a final score rated on 30-point scale.</li>
	</ol>
	</li>
</ol>

<ol>
	<li>Steele, C. M., Aronson, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stereotype+threat+and+the+intellectual+test+performance+of+African+Americans.">Stereotype threat and the intellectual test performance of African Americans.</a> Journal of Personality and Social Psychology. 69 (5), 797-811 (1995).</li><li>Steele, C. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+threat+in+the+air:+How+stereotypes+shape+intellectual+identity+and+performance.">A threat in the air: How stereotypes shape intellectual identity and performance.</a> American Psychologist. 52, 613-629 (1997).</li><li>Barber, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+examination+of+age-based+stereotype+threat+about+cognitive+decline:+Implications+for+stereotype-threat+research+and+theory+development.">An examination of age-based stereotype threat about cognitive decline: Implications for stereotype-threat research and theory development.</a> Perspectives on Psychological Science. 12 (1), 62-90 (2017).</li><li>Chasteen, A. L., Kang, S. K., Remedios, J. D., Inzlicht, M., Schmader, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aging+and+stereotype+threat:+Development,+process,+and+interventions.">Aging and stereotype threat: Development, process, and interventions.</a> Stereotype threat: Theory, process, and application. , 202-216 (2012).</li><li>Lamont, R. A., Swift, H. J., Abrams, D. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Review+and+Meta-Analysis+of+Age-Based+Stereotype+Threat:+Negative+Stereotypes,+Not+Facts,+Do+the+Damage.">Review and Meta-Analysis of Age-Based Stereotype Threat: Negative Stereotypes, Not Facts, Do the Damage.</a> Psychology and Aging. 30 (1), 180-193 (2015).</li><li>Haslam, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term="When+the+age+is+in,+the+wit+is+out":+Age+related+self-categorization+and+deficit+expectations+reduce+performance+on+clinical+tests+used+in+dementia+assessment.">"When the age is in, the wit is out": Age related self-categorization and deficit expectations reduce performance on clinical tests used in dementia assessment.</a> Psychology and Aging. 27, 778-784 (2012).</li><li>Desrichard, O., K&#246;petz, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+threat+in+the+elder:+The+impact+of+task-instructions,+self-efficacy+and+performance+expectations+on+memory+performance+in+the+elderly.">A threat in the elder: The impact of task-instructions, self-efficacy and performance expectations on memory performance in the elderly.</a> European Journal of Social Psychology. 35, 537-552 (2005).</li><li>Kang, S. K., Chasteen, A. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+moderating+role+of+age-group+identification+and+perceived+threat+on+stereotype+threat+among+older+adults.">The moderating role of age-group identification and perceived threat on stereotype threat among older adults.</a> The International Journal of Aging and Human Development. 69, 201-220 (2009).</li><li>Rahhal, T. A., Hasher, L., Colcombe, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Instructional+manipulations+and+age+differences+in+memory:+Now+you+see+them,+now+you+don't.">Instructional manipulations and age differences in memory: Now you see them, now you don't.</a> Psychology and Aging. 16, 697-706 (2001).</li><li>Hess, T. M., Auman, C., Colcombe, S. J., Rahhal, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Impact+of+Stereotype+Threat+on+Age+Differences+in+Memory+Performance.">The Impact of Stereotype Threat on Age Differences in Memory Performance.</a> The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 58 (1), P3-P11 (2003).</li><li>Hess, T. M., Hinson, J. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Age-related+variation+in+the+influences+of+aging+stereotypes+on+memory+in+adulthood.">Age-related variation in the influences of aging stereotypes on memory in adulthood.</a> Psychology and Aging. 21 (3), 621-625 (2006).</li><li>Levy, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+memory+in+old+age+through+implicit+self-stereotyping.">Improving memory in old age through implicit self-stereotyping.</a> Journal of Personality and Social Psychology. 71, 1092-1107 (1996).</li><li>Stein, R., Blanchard-Fields, F., Hertzog, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+age-stereotype+priming+on+the+memory+performance+of+older+adults.">The effects of age-stereotype priming on the memory performance of older adults.</a> Experimental Aging Research. 28 (2), 169-181 (2002).</li><li>Sachdev, P. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sydney+Memory,+Ageing+Study+Team.+Factors+predicting+reversion+from+mild+cognitive+impairment+to+normal+cognitive+functioning:+a+population-based+study.">Sydney Memory, Ageing Study Team. Factors predicting reversion from mild cognitive impairment to normal cognitive functioning: a population-based study.</a> PloS One. 8, e59649 (2013).</li><li>R&#233;gner, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aging+stereotypes+must+be+taken+into+account+for+the+diagnosis+of+prodromal+and+early+Alzheimer's+disease.">Aging stereotypes must be taken into account for the diagnosis of prodromal and early Alzheimer's disease.</a> Alzheimer Disease &amp; Associated Disorders - An International Journal. 30 (1), 77-79 (2016).</li><li>Chasteen, A. L., Bhattacharyya, S., Horhota, M., Tam, R., Hasher, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+feelings+of+stereotype+threat+influence+older+adults'+memory+performance.">How feelings of stereotype threat influence older adults' memory performance.</a> Experimental Aging Research. 31 (3), 235-260 (2005).</li><li>Yesavage, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+and+validation+of+a+geriatric+depression+screening+scale:+a+preliminary+report.">Development and validation of a geriatric depression screening scale: a preliminary report.</a> Journal of Psychiatric Research. 17 (1), 37-49 (1982).</li><li>Spielberger, C. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Test+Anxiety+Inventory.">Test Anxiety Inventory.</a> The Corsini Encyclopedia of Psychology. , (2010).</li><li>Folstein, M. F., Folstein, S. E., McHugh, P. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term="Mini-mental+state.".">"Mini-mental state.".</a> Journal of Psychiatric Research. 12 (3), 189-198 (1975).</li><li>Crum, R. M., Anthony, J. C., Bassett, S. S., Folstein, M. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Population-based+norms+for+the+Mini-Mental+State+Examination+by+age+and+educational+level.">Population-based norms for the Mini-Mental State Examination by age and educational level.</a> The Journal of the American Medical Association. 269 (18), 2386-2391 (1993).</li><li>Gimmig, D., Huguet, P., Caverni, J. -. P., Cury, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Choking+under+pressure+and+working-memory+capacity:+When+performance+pressure+reduces+fluid+intelligence.">Choking under pressure and working-memory capacity: When performance pressure reduces fluid intelligence.</a> Psychonomic Bulletin &amp; Review. 13, 1005-1010 (2006).</li><li>Mazerolle, M., R&#233;gner, I., Morisset, P., Rigalleau, F., Huguet, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stereotype+Threat+Strengthens+Automatic+Recall+and+Undermines+Controlled+Processes+in+the+Elderly.">Stereotype Threat Strengthens Automatic Recall and Undermines Controlled Processes in the Elderly.</a> Psychological Science. 23, 723-727 (2012).</li><li>Daneman, M., Carpenter, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Individual+differences+in+working+memory+and+reading.">Individual differences in working memory and reading.</a> Journal of Verbal Learning and Verbal Behavior. 19, 450-466 (1980).</li><li>Nasreddine, Z. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Montreal+Cognitive+Assessment,+MoCA:+A+brief+screening+tool+for+mild+cognitive+impairment.">The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment.</a> Journal of the American Geriatrics Society. 53, 695-699 (2005).</li><li>Mazerolle, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Negative+Aging+Stereotypes+Impair+Performance+on+Brief+Cognitive+Tests+Used+to+Screen+for+Predementia.">Negative Aging Stereotypes Impair Performance on Brief Cognitive Tests Used to Screen for Predementia.</a> Journals of Gerontology, Series B: Psychological Sciences and Social Sciences. 72 (6), 932-936 (2017).</li><li>Brown, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+and+misuse+of+short+cognitive+tests+in+the+diagnosis+of+dementia.">The use and misuse of short cognitive tests in the diagnosis of dementia.</a> Journal of Neurology, Neurosurgery, and Psychiatry. 86, 680-685 (2015).</li><li>Le Couteur, D. G., Doust, J., Creasey, H., Brayne, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Political+drive+to+screen+for+pre-dementia:+not+evidence+based+and+ignores+the+harms+of+diagnosis.">Political drive to screen for pre-dementia: not evidence based and ignores the harms of diagnosis.</a> BMJ. 347, f5125 (2013).</li><li>Steele, C. M., Davies, P. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stereotype+Threat+and+Employment+Testing:+A+Commentary.">Stereotype Threat and Employment Testing: A Commentary.</a> Human Performance. 16 (3), 311-326 (2003).</li><li>Scholl, J. M., Sabat, S. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stereotypes,+stereotype+threat+and+ageing:+implications+for+the+understanding+and+treatment+of+people+with+Alzheimer&#39;s+disease.">Stereotypes, stereotype threat and ageing: implications for the understanding and treatment of people with Alzheimer&#39;s disease.</a> Ageing &amp; Society. 28 (1), 103-130 (2008).</li><li>Suhr, J. A., Gunstad, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term="Diagnosis+threat":+The+effect+of+negative+expectations+on+cognitive+performance+in+head+injury.">"Diagnosis threat": The effect of negative expectations on cognitive performance in head injury.</a> Journal of Clinical and Experimental Neuropsychology. 24 (4), 448-457 (2002).</li><li>Schlemmer, M., Desrichard, O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Is+Medical+Environment+Detrimental+to+Memory?+A+Test+of+A+White+Coat+Effect+on+Older+People's+Memory+Performance.">Is Medical Environment Detrimental to Memory? A Test of A White Coat Effect on Older People's Memory Performance.</a> Clinical Gerontologist. 41 (1), 77-81 (2018).</li></ol>

The authors have nothing to disclose.

The present studies show that stereotype threat, a neglected source of stress in many testing situations, can lead older adults to perform below their true abilities on memory tests. The method presented here highlights the crucial importance of the instructions given to participants and patients before testing memory. Simply mentioning that younger adults are taking part in the study (without mentioning any expected age-related differences in performance) is sufficient to inflate by 40% (MMSE and MoCA averaged) the numb...

A growing field of laboratory research in social cognition conducted in the healthy population has demonstrated that members of groups whose abilities are negatively stereotyped typically underperform when the negative stereotypes are made relevant to the performance at hand, a phenomenon called stereotype threat (ST). In addition to the normal anxiety associated with taking cognitive tests, the fear of confirming negative stereotypes creates extra pressure that may interfere with cognitive functioning and lead to perform below one&#39;s abilities1,2. Many findings demonstrate that negative aging stereotypes (e.g., the culturally shared beliefs that aging inescapably causes severe cognitive decline and diseases such as Alzheimer&#39;s disease [AD]) contribute, at least in part, to the differences classically observed in the healthy population between younger and older adults in memory tasks3,4,5. Without denying the impact of aging on cognitive functioning, research clearly demonstrates that age-related stereotypes are powerful enough to artificially decrease older adults&#39; performance on memory tests.
Detrimental age-based ST effects are readily observable and fairly easy to produce with instructional manipulations6, such as simply emphasizing the memory component of the test7,8,9, highlighting differences in performance between young and older adults10,11, or implicitly activating negative aging stereotypes12,13. Given the results obtained in laboratory studies, it is very likely that negative aging stereotypes also permeate, at least implicitly, the standard neuropsychological testing settings during the screening for pre-dementia. Indeed, because of the lengthening of life expectancy, more and more people are concerned with the possibility of getting AD or other forms of dementia. Importantly, false-positive errors are quite frequent in the diagnosis of prodromal state of AD14, which could be explained, at least in part, by transitory impaired performances in older adults due to the age-based ST phenomenon15.
For these reasons, it is important to provide efficient methods to deactivate the influence of negative aging stereotypes and thereby help older people to perform at their maximum during memory assessment in general and during neuropsychological testing specifically. Some methods, such as de-emphasizing the memory component of the test (e.g., characterizing the task as a vocabulary test), have already proved efficient to eliminate ST effects in older adults on explicit memory tests taken in the context of lab studies7,9,16. However, such instructions are not compatible with the ecological clinical context of the neuropsychological testing, in which older adults come to have their memory abilities assessed. The goal of our articles is to present two methods likely to alleviate age-based ST effects among older adults, either in the lab or in the clinical contexts. The first one, especially suited for the lab context, consists in telling older adults that performance on the ongoing memory tests usually does not differ between younger and older adults (i.e., age-fair instructions). The second method, which can be implemented in both lab and clinical contexts, consists in explaining to older adults (or patients) the negative impact of aging stereotypes, which may help them reappraise the situation, reduce evaluative pressure, and feel less threatened during the testing.

<table>
	<tbody>
		<tr>
			<td>Table</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>2 chairs (one for the participant and one for experimenter)</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Laptop/computer with Reading span test described in the protocol</td>
			<td>Apple iMac (Cupertino, CA)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Software</td>
			<td>Psyscope</td>
			<td></td>
			<td><a href="http://psy.ck.sissa.it/psy_cmu_edu/index.html" target="_blank">http://psy.ck.sissa.it/psy_cmu_edu/index.html</a></td>
		</tr>
		<tr>
			<td>Paper and pencil for MMSE, MoCA, Geriatric depression Scale, State-Trait Anxiety Inventory</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Mini Mental State Examination</td>
			<td>Folstein, M. F., Folstein, S. E., McHugh, P. R. &#34;Mini-mental state.&#34; Journal of Psychiatric Research. 12 (3), 189&#8211;198 (1975).</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Montreal Cognitive Assessment</td>
			<td>Nasreddine, Z. S. et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society. 53, 695&#8211;699 (2005).</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Geriatric depression Scale</td>
			<td>Spielberger, C. D. Test Anxiety Inventory. The Corsini Encyclopedia of Psychology. John Wiley &#38; Sons, Inc., Hoboken (2010).</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>State-Trait Anxiety Inventory</td>
			<td>Yesavage, J. A. et al. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research. 17 (1), 37&#8211;49 (1982).</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
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highlighting and reducing the impact of negative aging stereotypes during older adults' cognitive testing

As life expectancy increases, aging has become a major health challenge, resulting in a huge effort to better discriminate between normal and pathological cognitive decline. It is thus essential that cognitive tests and their administration are as fair as possible. However, an important source of bias during cognitive testing comes from negative aging stereotypes that can impair the memory performance of older adults and inflate age differences on cognitive tasks. The fear of confirming negative aging stereotypes creates an extra pressure among older adults which interferes with their intellectual functioning and leads them to perform below their true abilities. Here, we present a protocol that highlights simple but efficient interventions to alleviate this age-based stereotype threat effect. The first study showed that simply informing older participants about the presence of younger participants (threat condition) led older adults to underperform on a standardized memory test compared with younger participants, and that this performance difference was eliminated when the test was presented as age-fair (reduced-threat condition). The second study replicated these findings on short cognitive tests used to screen for predementia in clinical settings and showed that teaching older adults about stereotype threat inoculated them against its effects. These results provide useful recommendations about how to improve older adults' memory assessment both in Iab studies and in clinical settings.

We addressed the hypothesis that stereotype threat impairs the working memory performance of older adults and that this effect can be reduced or eliminated by a simple instruction. The expected interaction between age group and threat instructions was significant, F(1, 214) = 4.85, p &#60; 0.03, &#951;p2 = 0.02, and is depicted in Figure 3. In the threat condition, older participants underperformed (mean [M] = ...

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Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Here, we present a protocol designed to show how negative aging stereotypes can impair memory performance of older adults during cognitive testing and how to reduce this deleterious effect. This method can help older people to perform at an optimal level during testing in both lab studies and clinical settings.

As life expectancy increases, aging has become a major health challenge, resulting in a huge effort to better discriminate between normal and pathological ...

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Universidad de Cartagena UDEC

Research

Education

JoVE Journal

JoVE Core

Social Psychology

Behavior

Foundations of Social Psychology

Stereotypes, Prejudice, and Discrimination

SCIENTISTS IN ACTION

7.2K Views.  Université Bourgogne Franche-Comté. Here, we present a protocol designed to show how negative aging stereotypes can impair memory performance of older adults during cognitive testing and how to reduce this deleterious effect. This method can help older people to perform at an optimal level during testing in both lab studies and clinical settings.

Video: Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Irrelevant Stimuli and Action Control: Analyzing the Influence of Ignored Stimuli via the Distractor-Response Binding Paradigm

Selection tasks in which simple stimuli (e.g. letters) are presented and a target stimulus has to be selected against one or more distractor stimuli are frequently used in the research on human action control. One important question in these settings is how distractor stimuli, competing with the target stimulus for a response, influence actions. The distractor-response binding paradigm can be used to investigate this influence. It is particular useful to separately analyze response retrieval and distractor inhibition effects. Computer-based experiments are used to collect the data (reaction times and error rates). In a number of sequentially presented pairs of stimulus arrays (prime-probe design), participants respond to targets while ignoring distractor stimuli. Importantly, the factors response relation in the arrays of each pair (repetition vs. change) and distractor relation (repetition vs. change) are varied orthogonally. The repetition of the same distractor then has a different effect depending on response relation (repetition vs. change) between arrays. This result pattern can be explained by response retrieval due to distractor repetition. In addition, distractor inhibition effects are indicated by a general advantage due to distractor repetition. The described paradigm has proven useful to determine relevant parameters for response retrieval effects on human action.

The distractor-response binding paradigm is described. It can be used to shed light on the influence irrelevant stimuli, competing with targets for a response, can have on human action. Both response retrieval effects and distractor inhibition effects can be analyzed within the paradigm.

Selection tasks in which simple stimuli (e.g. letters) are presented and a target stimulus has to be selected against one or more distractor stimuli are ...

Behavioral Assessment of the Aging Mouse Vestibular System

Age related decline in balance performance is associated with deteriorating muscle strength, motor coordination and vestibular function. While a number of studies show changes in balance phenotype with age in rodents, very few isolate the vestibular contribution to balance under either normal conditions or during senescence. We use two standard behavioral tests to characterize the balance performance of mice at defined age points over the lifespan: the rotarod test and the inclined balance beam test. Importantly though, a custom built rotator is also used to stimulate the vestibular system of mice (without inducing overt signs of motion sickness). These two tests have been used to show that changes in vestibular mediated-balance performance are present over the murine lifespan. Preliminary results show that both the rotarod test and the modified balance beam test can be used to identify changes in balance performance during aging as an alternative to more difficult and invasive techniques such as vestibulo-ocular (VOR) measurements.

Motor control and balance performance are known to deteriorate with age. This paper presents a number of standard noninvasive behavioral tests with the addition of a simple rotary stimulus to challenge the vestibular system and show changes in balance performance in a murine model of aging.

Age related decline in balance performance is associated with deteriorating muscle strength, motor coordination and vestibular function. While a number of ...

Getting to Compliance in Forced Exercise in Rodents: A Critical Standard to Evaluate Exercise Impact in Aging-related Disorders and Disease

There is a major increase in the awareness of the positive impact of exercise on improving several disease states with neurobiological basis; these include improving cognitive function and physical performance. As a result, there is an increase in the number of animal studies employing exercise. It is argued that one intrinsic value of forced exercise is that the investigator has control over the factors that can influence the impact of exercise on behavioral outcomes, notably exercise frequency, duration, and intensity of the exercise regimen. However, compliance in forced exercise regimens may be an issue, particularly if potential confounds of employing foot-shock are to be avoided. It is also important to consider that since most cognitive and locomotor impairments strike in the aged individual, determining impact of exercise on these impairments should consider using aged rodents with a highest possible level of compliance to ensure minimal need for test subjects. Here, the pertinent steps and considerations necessary to achieve nearly 100% compliance to treadmill exercise in an aged rodent model will be presented and discussed. Notwithstanding the particular exercise regimen being employed by the investigator, our protocol should be of use to investigators that are particularly interested in the potential impact of forced exercise on aging-related impairments, including aging-related Parkinsonism and Parkinson&#8217;s disease.

Exercise may alleviate behavioral impairments associated with neurodegenerative diseases. Studies of the mechanisms underlying exercise-mediated effects have increased in disease models, but the neurobiological background accompanying these diseases, specifically aging, is likely not considered. Here, we illustrate measures to increase the likelihood of a successful exercise paradigm in aged rats.

There is a major increase in the awareness of the positive impact of exercise on improving several disease states with neurobiological basis; these ...

Community-based Adapted Tango Dancing for Individuals with Parkinson's Disease and Older Adults

Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple step elements. Adapted tango involves movement initiation and cessation, multi-directional perturbations, varied speeds and rhythms. Focus on foot placement, whole body coordination, and attention to partner, path of movement, and aesthetics likely underlie adapted tango&#8217;s demonstrated efficacy for improving mobility and balance. In this paper, we describe the methodology to disseminate the adapted tango teaching methods to dance instructor trainees and to implement the adapted tango by the trainees in the community for older adults and individuals with Parkinson&#8217;s Disease (PD). Efficacy in improving mobility (measured with the Timed Up and Go, Tandem stance, Berg Balance Scale, Gait Speed and 30 sec chair stand), safety and fidelity of the program is maximized through targeted instructor and volunteer training and a structured detailed syllabus outlining class practices and progression.

Adapted tango has demonstrated efficacy for improving mobility and balance. We describe the dissemination of adapted tango teaching methods to dance instructor trainees and the implementation of adapted tango by the trainees in the community for improving mobility and balance in older adults and individuals with Parkinson&#8217;s disease.

Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple ...

Measuring Attentional Biases for Threat in Children and Adults

Investigators have long been interested in the human propensity for the rapid detection of threatening stimuli. However, until recently, research in this domain has focused almost exclusively on adult participants, completely ignoring the topic of threat detection over the course of development. One of the biggest reasons for the lack of developmental work in this area is likely the absence of a reliable paradigm that can measure perceptual biases for threat in children. To address this issue, we recently designed a modified visual search paradigm similar to the standard adult paradigm that is appropriate for studying threat detection in preschool-aged participants. Here we describe this new procedure. In the general paradigm, we present participants with matrices of color photographs, and ask them to find and touch a target on the screen. Latency to touch the target is recorded. Using a touch-screen monitor makes the procedure simple and easy, allowing us to collect data in participants ranging from 3 years of age to adults. Thus far, the paradigm has consistently shown that both adults and children detect threatening stimuli (e.g., snakes, spiders, angry/fearful faces) more quickly than neutral stimuli (e.g., flowers, mushrooms, happy/neutral faces). Altogether, this procedure provides an important new tool for researchers interested in studying the development of attentional biases for threat.

Here we describe a touch-screen visual search paradigm that can be used to study threat detection across the lifespan. The paradigm has already been used in various studies demonstrating that both children and adults detect threatening stimuli like snakes, spiders, and angry faces faster than non-threatening stimuli.

Investigators have long been interested in the human propensity for the rapid detection of threatening stimuli. However, until recently, research in this ...

Substantiating Appropriate Motion Capture Techniques for the Assessment of Nordic Walking Gait and Posture in Older Adults

Nordic walking (NW) has become a safe and simple form of exercise in recent years, and in studying this gait pattern, various data collection techniques have been employed, each with positives and negatives. The aim was to determine the effect of NW on older adult gait and posture and to determine optimal use of different data collection systems in both short and long duration analysis. Gait and posture during NW and normal walking were assessed in 17 healthy older adults (age: 69 &#177; 7.3). Participants performed two trials of 6 Minute Walk Tests (6MWT) (1 with poles (WP) and 1 without poles (NP)) and 6 trials of a 5m walk (3 WP and 3 NP). Motion was recorded using two systems, a 6-sensor accelerometry system and an 8-camera 3-dimensional motion capture system, in order to quantify spatial-temporal, kinematic, and kinetic parameters.
With both systems, participants demonstrated increased stride length and double support and decreased gait speed and cadence WP compared to NP (p &#60;0.05). Also, with motion capture, larger single support time was found WP (p &#60;0.05). With 3-D capture, smaller hip power generation and moments of force were found at heel contact and pre-swing as well as smaller knee power absorption at heel contact, pre-swing, and terminal swing WP compared to NP, when assessed over one cycle (p &#60;0.05). Also, WP yielded smaller moments of force at heel contact and terminal swing along with larger moments at mid-stance of a gait cycle (p &#60;0.05). No changes were found for posture.
NW seems appropriate for promoting a normal gait pattern in older adults. Three-dimensional motion capture should primarily be used during short duration gait analysis (i.e. single gait cycle), while accelerometry systems should be primarily employed in instances requiring longer duration analysis such as during the 6MWT.

The aim was to substantiate optimal use of data collection techniques for Nordic walking gait and posture analysis. Three-dimensional motion capture should be used during short duration analysis (i.e. single gait cycle), while accelerometry should be employed for longer duration analysis (i.e. repeated cycles) like a 6 Minute Walk Test.

Nordic walking (NW) has become a safe and simple form of exercise in recent years, and in studying this gait pattern, various data collection techniques ...

Reducing State Anxiety Using Working Memory Maintenance

The purpose of this protocol is to explain how to examine the relationship between working memory processes and anxiety by combining the Sternberg Working Memory (WM) and the threat of shock paradigms. In the Sternberg WM paradigm, subjects are required to maintain a series of letters in the WM for a brief interval and respond by identifying whether the position of a given letter in the series matches a numerical prompt. In the threat of shock paradigm, subjects are exposed to alternating blocks where they are either at risk of receiving unpredictable presentations of a mild electric shock or are safe from the shock. Anxiety is probed throughout the safe and threat blocks using the acoustic startle reflex, which is potentiated under threat (Anxiety-Potentiated Startle (APS)). By conducting the Sternberg WM paradigm during the threat of shock and probing the startle response during either the WM maintenance interval or the intertrial interval, it is possible to determine the effect of WM maintenance on APS.

This protocol demonstrates how to measure anxiety-potentiated startle during the Sternberg Working Memory paradigm.

The purpose of this protocol is to explain how to examine the relationship between working memory processes and anxiety by combining the Sternberg Working ...

Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults

A real-time locating system (RTLS) can be used to track the walking activity of institutionalized older adults in long-term care who are at risk for wandering behaviors. The benefits of a RTLS are objective and continuous measurements of activity. Self-report methods of activity, especially wandering, by health care staff are vulnerable to floor effects and recall bias, and continuous clinical or research observation over the long-term can be time-consuming and expensive. Health care staff also fail to recognize the onset and/or duration of wandering behaviors, which are associated with a variety of adverse health outcomes in this population but amenable to intervention. RTLS technologies can measure the walking activity of institutionalized residents with cognitive impairment over time with a high degree of accuracy. This is particularly useful for the study of wandering, defined as walking for at least 60 seconds with few (if any) breaks in activity. Wandering is associated with disease progression, hospitalizations, falls and death. Previous work suggests older adults with poor balance ability and high sustained walking activity may be particularly susceptible to poor health outcomes. RTLS&#39;s are used to assess cognitive impairment and factors associated with gait and balance; however, supplemental paper and pencil gait/balance tools may be used to further refine risk profiles. This project discusses the use of a RTLS to measure walking activity and also gait quality and balance ability measures on this population.

This paper discusses the use of a continuous and objective real-time locating system to measure walking activity associated with wandering behaviors, focusing on older adults with cognitive impairment. Walking activity is measured by walking distance, sustained walking distance, and sustained gait speed. Also assessed are gait quality and balance ability.

A real-time locating system (RTLS) can be used to track the walking activity of institutionalized older adults in long-term care who are at risk for ...

Dissociation of the Confounding Influences of Expectancy and Integrative Difficulty Residing in Anomalous Sentences in Event-related Potential Studies

The confounding factors of unexpectedness and semantic integration difficulty naturally residing in anomalous sentences in language studies make it difficult to determine the underlying processing mechanism of ERP components. Unlike the traditional static approach of manipulating expectancy through corpus frequency or cloze probability, this protocol proposes a dynamic method to enhance participants&#39; expectancy for rarely-met anomalous sentences by multiple repetitions while maintaining their semantic integration difficulties. To address the time cost increase resulting from multiple repetitions, this protocol proposes to repeat only the strictly simplified core structure extracted from the anomalous sentence before presenting the semantically enriched, much more informative complete anomalous sentence containing the anomalous core structure to reinitiate the semantic integration processing. The complete anomalous sentence elicited a P600 effect. It suggests that the participants did not give up processing the anomalous information after repetitions and the same semantic integration difficulty was successfully reinitiated. Importantly, the representative experimental results reveal that the greatly attenuated N400 effect caused by multiple repetitions was not recovered by the follow-up reinitiated semantic integration difficulty. It suggests that the attenuated N400 effect should be mainly attributed to the enhancement of expectancy for anomalous information by multiple repetitions. The experimental results show that this method can effectively enhance participants&#39; expectancy for anomalous sentences while retaining the semantic integration difficulty.

We present a protocol to dissociate the intertwining factors of integrative difficulty and unexpectedness in semantically anomalous sentences by applying multiple repetitions to enhance participant&#39;s expectancy for anomalous sentences. The dissociation helps to investigate the major contributor of elicited event-related potentials (ERP) effects such as N400 in language studies.

The confounding factors of unexpectedness and semantic integration difficulty naturally residing in anomalous sentences in language studies make it ...

Using the Race Model Inequality to Quantify Behavioral Multisensory Integration Effects

Multisensory integration research investigates how the brain processes simultaneous sensory information. Research on animals (mainly cats and primates) and humans reveal that intact multisensory integration is crucial for functioning in the real world, including both cognitive and physical activities. Much of the research conducted over the past several decades documents multisensory integration effects using diverse psychophysical, electrophysiological, and neuroimaging techniques. While its presence has been reported, the methods used to determine the magnitude of multisensory integration effects varies and typically faces much criticism. In what follows, limitations of previous behavioral studies are outlined and a step-by-step tutorial for calculating the magnitude of multisensory integration effects using robust probability models is provided.

The current study aims to provide a step-by-step tutorial for calculating the magnitude of multisensory integration effects in an effort to facilitate the production of translational research studies across diverse clinical populations.

Multisensory integration research investigates how the brain processes simultaneous sensory information. Research on animals (mainly cats and primates) ...