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Cognitive training improves mental abilities in older adults, but the benefit to minority elders is unclear. We conducted a subgroup analysis of subjects in the SeniorWISE (Wisdom Is Simply Exploration) trial to examine this issue. Design and Methods: SeniorWISE was a Phase 3 randomized trial that enrolled 265 nondemented communitydwelling older adults aged 65 years and older between 2001 and 2006. Participants were randomly assigned to 12 hr of either memory or health training. Results: The sample was 79% female, 71% Caucasian, 17% Hispanic, and 12% African American. On the Rivermead Behavioural Memory Test (RBMT), 28% of the sample scored normal, 47% scored poor, and 25% impaired. Memory performance changed differently over time depending on the demographic characteristics of participants. Both Hispanics and Blacks performed better than Whites on visual memory, and Blacks performed better over time on instrumental activities of daily living. On all performance measures, lower pretest scores were associated with relatively greater improvements over time. Implications: Our analyses suggested that minority participants received differential benefits from the memory training; however, this remains speculative because the 3 ethnic groups in the sample were not equivalent in size. The question of why Black and Hispanic participants often made greater improvements needs further exploration.

The mental health of cancer survivors has not always been the primary emphasis of treatment protocols since physical health outcomes have taken precedence. Older cancer survivors experience a double jeopardy since they are at risk for memory impairments and mild cognitive impairment and because they are greater than 55 years of age. Of the 9.6 million cancer survivors in the US who have completed active treatment, many report cognitive difficulties, with labels such as "chemo brain," "not as sharp," "woolly-headedness," or the "mind does not work as quickly". To date, most of our knowledge of cognitive impairment in cancer survivors comes from female breast cancer survivors. Studies indicate that these survivors have diminished executive function, verbal memory, and motor function. Cancer survivors want to live independently in the community for as long as possible however, these cognitive deficits may prevent this desired lifestyle. To broade...

The study reported here was a secondary analysis of data on 157 males from a larger study of predictors of memory performance in community-dwelling elders. The males' average age was 76 years, with 13 years of education and a Mini-Mental State Exam score of 26. Measures included depression, memory performance, metamemory, and memory self-efficacy. An unusual finding was the multimodal distribution of memory self-efficacy strength scores. Using a median split, the sample was divided into low and high memory self-efficacy groups. The high efficacy group were significantly younger, had larger scores on capacity (+ = high capacity) and change (+ = greater stability). These findings provide new evidence that the memory self-efficacy of aging males influences their perceptions of cognitive performance related to memory.

This pre-post quasiexperimental study tested the eight-session Cognitive Behavioral Model of Everyday Memory in residents (58 women, 20 men) of a retirement village in Northeast Ohio. Their average age was 82 years, with 16 years of education and Mini-Mental State Examination score of 28; 13% were depressed. All participants were pretested and posttested at 8 weeks. The largest gains were in memory self-efficacy and use of internal memory strategies. Moderate gains were made in instrumental activities and change, and smaller gains were made in locus and memory performance. The dose of the intervention (eight sessions) was adequate, and practice in each class session facilitated mastery of memory strategies and techniques.

We tested whether at-risk older adults receiving memory training showed better memory selfefficacy, metamemory, memory performance, and function in instrumental activities of daily living than participants receiving a health promotion training comparison condition. We followed participants for 26 months. The sample was mostly female (79%) and Caucasian (71%), with 17% Hispanics, and 12% African Americans; average age was 75 years and average education was 13 years. The memory training group made greater gains on global cognition and had fewer memory complaints, but both groups generally maintained their performance on the other cognitive measures and IADLs throughout the 24-month study period. Black and Hispanic participants made greater gains than Whites did on some memory performance measures but not on memory self-efficacy. The unexpected finding that minority elders made the largest gains merits further study. This study contributed to the knowledge base of geropsychiatric nursing by providing evidence for an effective psychosocial intervention that could be delivered by advanced practice nurses.

Cancer survivors over 65 years of age experience treatment-induced memory impairments. However, clinicians are often at a loss on how to intervene for these cognitive problems. This paper describes the findings from a pilot study of a memory vs. health training intervention and its adaptability for cancer survivors. Design and Methods-A convenience sample of older adults was enrolled in a longitudinal study of a memory and health training intervention and tested on five occasions for 2 years postintervention. The memory training was designed to reduce anxiety, decrease negative attributions, promote health, and increase self-efficacy. In this analysis we included change over time for the first four of the five data collection points. We calculated means and standard deviations on the memory measures for cancer survivors in the intervention (n=8) and comparison (n=14) groups. The analysis consisted of a mixed design ANOVA comparing the two intervention groups across 4 time periods for twelve months. Results-The typical cancer survivor in the sample was a 74-year old Caucasian female; 14% were minorities. Because of the small sample, some of the effects were not statistically significant. Moderate to large effects were revealed in everyday and verbal memory performance scores, memory self-efficacy, strategy use, and memory complaints. There were also moderate effects for group by time interactions on the visual memory performance measure, the memory self-efficacy measure, the depression, the trait anxiety measure, and the complaints subscale. The memory intervention group tended to improve more than the health training group, although this was not always consistent. The results suggested that the participants benefited from the memory training intervention.

Evidence that a reduced treatment achieves similar outcomes is beneficial because shorter interventions may be more cost-effective and more acceptable to participants. We examined the effects of shortening a memory intervention for elders from 8 sessions to 4 sessions. Shortening the intervention had little impact on either self-reported or performance measures of memory and daily living activities. Small to moderate effects were associated with positive change in both groups. When examining the cost-effectiveness, the 8-session intervention produced slightly greater gains in memory performance, but at a higher cost. Future studies should systematically vary key intervention components in more diverse samples.

As part of a larger clinical trial, SeniorWISE ™ (Wisdom Is Simply Exploration), this study provides baseline affective, cognitive, and functional ability data and reports on the likely incidence of mild cognitive impairment (MCI) in a triethnic community sample of older adults (N = 265). Seventyeight individuals had memory complaints, whereas 105 had none. Of the complainants, 32 had normal memory function and 46 had poor memory performance. Among those without memory complaints, 42 had no memory impairment and 63 had poor memory performance. Forty-six individuals (17%) met the criteria of poor everyday memory functioning and memory complaints whereas 81 (31%) would be considered to be at risk based on other MCI criteria. This pattern of results suggests that those with declining memory are less aware of their deficits in activities of daily living that their actual performance would suggest are occurring.

This paper describes the outcomes of a psychosocial intervention that tested whether health training could improve health and functional ability in a group community-residing elders. The health training intervention consisted of eight, 90-minute lecture and discussion classes conducted twice a week for one month. In 3 months following the post-test, an additional 4 booster sessions were delivered once per week for one month. Participants received a total of 20 hours of health training. The NIH-funded SeniorWISE© (Wisdom Is Simply Exploration) study was advertised in the community as a program to learn strategies for successful aging. We describe the health curriculum, and the health and functional outcomes for a 6-month period at pre-intervention, post-intervention, and post-booster sessions. Complete data were available for 110 individuals. There was a statistically significant change on the Direct Assessment of Functional Status (DAFS) (F = 4.69 (2, 107), p < .012). Health variables remained stable over time. This intervention demonstrated that health training has the potential for noticeable improvement in IADL function.

We examined the prevalence of depressive symptoms over time in a sample of community-residing older adults at baseline, 2 months, 6 months, and 14 months. The nonprobability sample (N = 222) was 90% female, 87% Caucasian, 15% Hispanic, and 12% African American with an average age of 75 years. If depressive symptoms had been measured at only one time, 19% of the sample would have scored above the cutoff versus 39% scoring above the cutoff when measured at all 4 periods. The findings provide evidence that depressive symptoms in older adults are variable and fluctuate over time. The significance of this research was the longitudinal evaluation of depressive symptoms in community-residing elders.

This quasi-experimental study examined the effectiveness of the Cognitive Behavioral Model of Everyday Memory (CBMEM) on memory self-efficacy and memory performance of the elderly. Thirty residents from a county nursing home in Northeast Ohio participated. Forty-three percent of the sample were depressed and 57% were cognitively impaired. There were 30 subjects in the experimental group. Class attendance was low (M = 4.48); the dropout rate was 58%. As a result, among the 30 individuals in the experimental group, posttest data were available for only 13 subjects. There were no pre-to posttest differences in total memory performance scores. However, immediate story recall significantly (p ≤.01) increased (M 1 =.67; M 2 = 1.33). The experimental group also made significant gains (p ≤.0001) in memory self-efficacy (M 1 = 35.84; M 2 = 41.87). While the intervention helped these vulnerable individuals improve their memory, future interventions may need to specifically target the problems of individuals with depression and those with cognitive impairments. Nevertheless, there is hope for improvement, as shown both here and in other memory improvement studies, and therefore the efforts to develop effective interventions need to continue.

This study tested the effects of a 4-week, nine-session group intervention taught in Spanish to Hispanic older adults entitled "Quieres Mejorar Tu Memoria" (Do you wish to improve your memory?). The program was based on Bandura's self-efficacy theory and was designed to increase memory self-efficacy and strategy use. A total of 33 older adults attending a senior center (mean-age = 69 years; education = 5 years; MMSE = 25) participated in the study. A booster session and a post-test were given at 3 months to the intervention group (n=22). At posttest the intervention reported greater confidence in preventing decline in their memories, and in particular greater use of the internal strategy of elaboration (2.99 vs. 3.41), and the external strategies of list (2.55 vs. 3.38) and note (3.27 vs. 3.75).

This paper describes strategies developed to recruit and retain an ethnically diverse sample in a longitudinal intervention of 246 participants in the SeniorWISE study. The ethnic and socioeconomic differences of these participants necessitated the use of different methods of effectively communicating with this population. Recruitment benefited from the use of focus groups, media attention, and personal appearances in the community. Educational strategies included modification of language and examples. Testing sessions were called interviews, and team members were available to answer questions and to read the instruments to participants, when desired. Participants were sent birthday cards and a monthly newsletter. The study is 90% completed. Providing educational interventions to individuals of widely divergent backgrounds in research settings can prove challenging to researchers and their teams. As the population of the United States ages and as the need for research populations become more diverse, knowledge of how to impart educational information gains importance. Previous researchers have acknowledged the need for improving recruitment and retention of older adults in research studies (Arean & Gallagher-Thompson, 1996). Moreover, research with different ethnic groups requires an understanding of their life experiences as they relate to research topics and to research itself (Lichtenberg, Brown, Jackson, & Washington, 2004; Shellman, 2004). Effective interventions must take into account these different life experiences. Longitudinal studies, in particular, require that recruitment techniques not only attract participants but also hold their interestso that attrition will be low. In such studies, success can be determined not only by generating data and disseminating findings in a timely and effective manner, but also by attracting and keeping a group of subjects. Such success depends on the willingness of the trainer and the team to become flexible, and to adapt the message to the target population. In this paper, we describe the strategies used to successfully recruit, retain, and instruct a diverse group of community elders in a longitudinal intervention study. PROJECT DESCRIPTION SeniorWISE, a research project based at the University of Texas at Austin, School of Nursing, was a study designed to enhance memory function in community-dwelling adults over the age of 65. Participants were randomly assigned to two conditions: an intervention designed to improve every day memory, or a comparison condition that discussed health information.

Twenty-six elders responded to an open-ended question as part of a study that examined the relationships among depression, health, memory self-efficacy, and metamemory. Participants rated their overall memory function as fair to average (M = 4.26, standard deviation [SD] = 1.29). The average memory efficacy scores were high (M = 51.35, SD = 23.56). The final question invited participants to share any additional information they thought might be important to this item. This article represents a content

Elderly cancer survivors report difficulty with attention, concentration, and memory. This study tested the effectiveness of the Cognitive Behavioral Model of Everyday Memory, an efficacy-based intervention designed to improve memory performance, memory self-efficacy, and metamemory in older adult cancer survivors and those with other chronic conditions. The study provides interesting new evidence that the responses of a group of elders to training varies depending on their health status.

C ancer of the lung and prostate represent the two primary cancers of men; the latter represents the second highest cause of cancer-related mortality in men (after lung cancer). Prostate cancer is a silent epidemic in this country and, if left untreated, can result in an agonizing death. The American Cancer Society 1 reports that an estimated 180,000 new cases of prostate cancer will be diagnosed this year and close to 40,000 deaths will be directly attributed to this slow-growing malignancy. According to Walsh, 2 that figure means a man is diagnosed with prostate cancer every 3 minutes and a death directly related to prostate cancer occurs every 15 minCE Article Geriatric Nursing 2000 • Volume 21 • Number 5 245 Instructions to CE enrollees: The closed-book, multiple-choice examination that follows this article is designed to test your understanding of the educational objectives listed below. The answer form is on page 241. On completion of this article, the reader should be able to: 1. Identify the prevalence of prostate cancer 2. Discuss the benefits and risks of prostate screening 3. Identify the difference between prostate cancer and benign prostate hypertrophy