Memory self-efficacy in cognitively normal older adults and older adults with mild cognitive

109 Pages·2017·0.53 MB·English

University of Iowa
Iowa Research Online
Theses and Dissertations
Fall 2012
Memory self-efficacy in cognitively normal older
adults and older adults with mild cognitive
impairment
Mary Ellen Stolder
University of Iowa
Copyright 2012 Mary Ellen Stolder
This dissertation is available at Iowa Research Online: https://ir.uiowa.edu/etd/5063
Recommended Citation
Stolder, Mary Ellen. "Memory self-efficacy in cognitively normal older adults and older adults with mild cognitive impairment." PhD
(Doctor of Philosophy) thesis, University of Iowa, 2012.
https://doi.org/10.17077/etd.glaw4nb4
Follow this and additional works at:https://ir.uiowa.edu/etd
Part of theNursing Commons
MEMORY SELF-EFFICACY IN COGNITIVELY NORMAL OLDER ADULTS
AND OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT

by
Mary Ellen Stolder

An Abstract
Of a thesis submitted in partial fulfillment
of the requirements for the Doctor of
Philosophy degree in Nursing
in the Graduate College of
The University of Iowa

December 2012

Thesis Supervisors: Professor Emeritus Kathleen Buckwalter
Professor Janet P. Specht
1

ABSTRACT
Although there are ample studies confirming that memory self-efficacy (MSE)
declines with age, less is known about what factors account for the variation in MSE
among older adults. The purpose of this study was to examine the relationship between
MSE, diagnostic and clinical characteristics, and subsequent episodic memory
performance in older adults. A nonprobability sample of 200 cognitively normal and
older adults with mild cognitive impairment (MCI) participating in a longitudinal
population-based study investigating the incidence, prevalence and risk factors for MCI
completed a questionnaire about self-referent beliefs of MSE. Bandura’s (1989) self-
efficacy theory and the Integration Model (Whittemore, 2005) informed the descriptive
study. Pearson product-moment correlations, a general linear model and a multiple linear
regression analysis were conducted. The difference in MSE ratings between the
cognitively normal group and the MCI group tested as a whole was significant when
adjusting for age, gender and educational attainment (p < .001; ES= 0.585). The overall
regression model explained 17 % of the variance of MSE (p < .001) and included age,
gender, educational attainment, APOE 4 genotype, family history of dementia, cognitive
diagnosis and depressive symptoms. After controlling for age and the other variables of
interest, cognitive classification and depression were significant predictors of MSE.
Higher MSE ratings were correlated with better episodic memory performance for both
groups (r = .273, p < .001). Memory training that capitalizes on the benefits accruing
from higher MSE is needed for cognitively normal older adults and older adults with
MCI.
Abstract Approved: ____________________________________
Thesis Supervisor
____________________________________
Title and Department
____________________________________
Date
2

Abstract Approved: ____________________________________
Thesis Supervisor
____________________________________
Title and Department
____________________________________
Date
MEMORY SELF-EFFICACY IN COGNITIVELY NORMAL OLDER ADULTS
AND OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT
by
Mary Ellen Stolder

A thesis submitted in partial fulfillment of the
requirements for the Doctor of
Philosophy degree in Nursing
in the Graduate College of
The University of Iowa

December 2012

Thesis Supervisors: Professor Emeritus Kathleen Buckwalter
Professor Janet P. Specht
Copyright by
MARY ELLEN STOLDER
2012
All Rights Reserved
Graduate College
The University of Iowa
Iowa City, Iowa
CERTIFICATE OF APPROVAL
_______________________
PH. D. THESIS
_______________
This is to certify that the Ph. D. thesis of

Mary Ellen Stolder

has been approved by the Examining Committee
for the thesis requirement for the Doctor of Philosophy
degree in Nursing at the December 2012 graduation.
Thesis Committee: ___________________________________
Kathleen Buckwalter, Thesis Supervisor
___________________________________
Janet P. Specht, Thesis Supervisor
___________________________________
Lioness Ayres
___________________________________
David Moser
___________________________________
Marianne Smith
Memory is the treasury and guardian of all things.
Cicero
ii
ACKNOWLEDGMENTS
This study is part of a NIA-funded investigation referred to as The Mayo Clinic
Olmsted Study of Aging. The principle investigator is Ronald Petersen. I would like to
express my appreciation for his kindness and willingness to take time from his busy
schedule to listen to my proposal and to provide his backing. The Mayo research team
earned my regard for their professionalism and willingness to send out yet another
questionnaire to research participants. Thanks, too, to Kevin Duff and Robin Whittemore
for their efforts on my behalf.
I would like to express my sincere gratitude to my advisor and mentor, Kathleen
Buckwalter, Ph.D., FAAN, for providing me with firm direction and arranging for me to
meet with her colleague Ronald Petersen. Additionally, I would like to thank all of my
committee members for their patience while I navigated through the IRB process at two
institutions. Having served as a research assistant for two committee members (Janet
Specht and Marianne Smith) and having completed a research practicum for a third
(David Moser), I learned firsthand from investigators devoted to their craft. From my
final committee member (Lioness Ayres), I acquired a genuine appreciation for
theoretical frameworks. I am indebted, too, to the John A. Hartford Foundation for
providing me with a predoctoral scholarship that enabled me to pursue full-time study.
Thanks especially to my 2008 cohort of doctoral students who provided me with a
sense of belonging. My family and friends deserve recognition for their forbearance not
only during my dissertation process but throughout my time in graduate school. Finally I
would like thank Megan Liu, Deb Brandt and Anthony Fina for their statistical know-
how and encouragement.
iii
TABLE OF CONTENTS
LIST OF TABLES ............................................................................................................. vi

LIST OF FIGURES .......................................................................................................... vii
CHAPTER I INTRODUCTION ...........................................................................1

Background .......................................................................................................1
Statement of the Problem ..................................................................................2
The Parent Study ...............................................................................................3
Purpose of the Study .........................................................................................4
Summary ...........................................................................................................6
CHAPTER II LITERATURE REVIEW ................................................................7

Definitions ........................................................................................................7
Theoretical Framework ...................................................................................15
Memory Changes Associated with Aging ......................................................20
Memory Self-Efficacy in Community-Dwelling Older Adults ......................23
Stereotype Threat ............................................................................................27
The Efficacy of Memore Training Interventions ............................................30
Summary .........................................................................................................31
CHAPTER III METHODOLOGY ........................................................................33

Study Design ...................................................................................................33
Sample ............................................................................................................34
Measures .........................................................................................................35
Procedures .......................................................................................................41
Data Management ...........................................................................................42
Descriptive Analysis .......................................................................................44
CHAPTER IV RESULTS ......................................................................................46

Characteristics of the Study Participants ........................................................46
Clinical and Demographic Characteristics of the Study Participants .............47
CHAPTER V DISCUSSION ................................................................................57

Overview of Study Findings ...........................................................................57
Limitations ......................................................................................................60
Implications and Future Research ..................................................................62

APPENDIX A MEMORY QUESTIONNAIRE ....................................................73

APPENDIX B MAYO CLINIC OLMSTED STUDY OF AGING IN-
PERSON EVALUATION .............................................................81
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