Abstract

The performance of older adults on neuropsychological (and cognitive) assessment tests can set the perspective on the capabilities of this population in general, hence contributing to ageism. These tests are administered with two implicit assumptions: (a) the tests are a valid gauge of performance in older adults and (b) cognitive abilities decline in older age. In the current chapter, we challenge these assumptions by discussing two potential sources of threat to test validity: the sensory and the social contexts. First, we review findings that age-related decline in performance may reflect, at least in part, a sensory (visual and auditory) rather than a purely cognitive decline. Next, we discuss the negative effect of age-based stereotype threat on older adults’ cognitive performance. Both contexts may be present in daily testing of older adults in the clinic or the lab. Thus, targeting the sensory and social context in neuropsychological assessment may assist in reducing age-bias (leading to ageism) in the scientific, medical and general community.

Highlights

  • Noting that declines in comprehension are often interpreted as a direct indication of age-related cognitive decline and even pre-dementia (Schneider et al 2005), these findings present implications for various neuropsychological assessment tools

  • We focus on commonly used screening tests for dementia such as the Mini-Mental State Examination (MMSE; Folstein et al 1975) and the Montreal Cognitive Assessment (MoCA: Nasreddine et al 2005)

  • This ageist bias might serve to further validate negative ageing stereotypes, resulting in the negative portrayal of older adults across both scientific literature and every day cultural representations. We discuss how such age-based stereotypes may have a negative impact on performance, suggesting that the social aspects of the test may put into question the validity of neuropsychological testing in ageing

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Summary

17.1 Introduction

Increase in life expectancy is one of the core characteristics of the modern life (Schneider 1999). We wish to challenge these assumptions, questioning the validity of cognitive tests as an unbiased gauge of older adults’ abilities, and as a result, questioning the extent of age-related cognitive decline. Performance on tests, which may be biased due to sensory and social aspects of ageing, confirms assumptions of reduced cognitive abilities in ageing. Our analysis of the literature focuses on the two main threats to the validity of neuropsychological assessment in ageing: the sensory context and the social context These contexts describe the mechanisms underlying biases in evaluating cognitive performance in older age, and offer insights that can improve the validity of such tests. ­neuropsychological assessment may assist in reducing age-bias (leading to ageism) in the scientific, medical and general community

17.2.1 Age-Related Sensory Decline
17.2.2 Theories on the Interaction of Sensory and Cognitive Ageing
17.2.3 Inhibition
17.2.4 Comprehension
17.2.5 Memory
17.2.6 Clinical Implications
Summary
17.3 The Social Context of Neuropsychological Assessment in Ageing
17.3.1 Age-Based Stereotype Threat
17.3.2 Clinical Implications of Age-Based Stereotype Threat
17.3.3 Understanding Stereotype Threat Effects
Findings
17.4 General Discussion

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