Abstract
Background: Previous research has suggested that older adults who are more cognitively active in later life show an attenuation in cognitive decline in healthy aging. Furthermore, cognitive intervention studies have indicated that ecologically valid cognitive interventions can promote cognitive functioning but only in taskspecific abilities. Since it has been shown that the art of self-testing can promote metacognitive awareness in older adults, attempting cryptic crosswords may be used as a cognitive intervention for older adults. Methods: In Experiments 1 and 2, a questionnaire technique was used and demonstrated that older adults became more aware of their episodic memory deficits after attempting cryptic crossword clues. Based on this, Experiment 3 used an intervention technique over a six-week period to investigate whether such awareness enabled older adults to improve cognitive functioning in a number of domains. This experiment used a revolutionary within-subjects technique to control for potential mediating factors. Results: The results supported previous research in that older adults showed an increase in the monitoring pathway of metacognition but were unable to use this enhanced awareness to change their behaviour when undertaking objective tests of cognitive ability. Post-hoc analysis highlighted subgroups of older adults who showed improvements in certain cognitive abilities, such as episodic memory functioning and judgement of learning abilities. Conclusions: The standard clinical trial technique might be inappropriate when testing either cognitive interventions or pharmacological tests. The within-subjects approach could be adapted to investigate follow-up effects of different types of interventions including ecologically valid cognitive interventions.
Highlights
Breast cancer is one of the most common malignancies of women in all over the world and in Iran [1]
The matched sonography or mammography cases with pathology reports and positive predictive value based on comparison between them and pathology report were determined as standard diagnostic criteria
According to the significant concordance between sonographyand mammography with core needle biopsy, these non-invasive methods can be helpful in diagnosing malignant lesions and differentiating them from benign lesions; they are affordable and available
Summary
Breast cancer is one of the most common malignancies of women in all over the world and in Iran [1]. According to the Iran cancer center reports in 2009, there were 7582 cases with breast cancer which 51% of them were diagnosed before 50 years old [2]. Khadivi et al reported the age of breast cancer incidence in Iran 10 years lower than western countries [3]. Based on Harirchi et al report, compared to other countries, there is a high frequency of cancer diagnosis of advanced levels in Iran [4]. Breast cancer is one of the most important and vital cancers leads to mortality in women. Diagnosis leads to improvement in treatment and survival [5]. Screening programs for the early diagnosis of breast cancer lead to perform several biopsies in order to determine the breast abnormalities found in sonography and mammography. According to gradually replacement of core needle biopsy instead of more invasive methods like open surgical biopsy, it seems necessary to study the concordance between biopsy results and non-invasive diagnostic methods in order to clarify ambiguous results and confirm the reliability of non-invasive methods
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