By: Laura LECRAC and Marine MORILLON
Commonly, the representation that has elderly people of aging contains several negative images. These images and ideas are called stereotypes. Negative stereotypes about aging impair performances, especially reflected in performances of brief cognitive tests which used to detect predemencia. Knowing that cognitive evaluation situations are associated with stress, Steele and Aronson (1995) have demonstrated that negative aging stereotypes create an interference with intellectual functioning and distort true abilities. This phenomenon according to negative stereotypes influences performances of elderly people is called: stereotype threat.
What are the consequences? Knowing that aging of the population is accompanied by cognitive impairment like memory or attention difficulties, more and more seniors are required to consult their doctor for cognitive tests in order to assess the presence or absence of dementia.
Thus, Mazerolle and collaborators (2016) conducted a study aiming to evaluate the impact of negative stereotypes on performance of the elderly in tests frequently used by doctors in the case of pre-dementia screening. Researchers tested 80 healthy elderly patients (approximately 75 years old) to whom they submitted two rapid assessment tests of cognitive functioning: the Mini Mental State Examination (MMSE, Folstein, Folstein & McHugh, 1975) and Montreal Cognitive Assessment (MoCA, Nasreddine et al., 2005). In order to measure the impact of these stereotypes, the study involved two conditions that varied the intensity of stereotypes: a threatening condition (i.e., negative stereotypes were present in participants’ minds) and a second where the threat of stereotypes was limited. In both conditions, people were informed that these tests were also performed by both young and elderly subjects. In the condition in which the threat was reduced, the examiner told participants that both older and younger people were generally successful in an equivalent way.
The results indicated that older people in threat condition had significantly lower performances than those placed under a limited threat. In addition, for 40% of individuals in the threatening condition, the results on both cognitive tests indicator of predementia.
In addition, the authors warn doctors about the impact of negative stereotypes when performing dementia screening. The researchers insist on providing the elderly with a safe environment so that they can carry out these tests on good conditions (i.e., not under the pressure of negative stereotypes). Indeed, the influence of stereotypes is such that it can lead elderly people to fail screening tests and to enter into diagnostic criteria of a pre-dementia. However, without these stereotypes, this diagnosis would not have occurred. During further examinations (i.e., case of neuropsychological evaluations), the effect of these stereotypes could lead to an erroneous diagnosis of dementia, and especially as people come in consultation with the fear of receiving a diagnosis of Alzheimer’s disease.
To conclude, the purpose of this study was to highlight that negative stereotypes about aging affect the performance of older people on cognitive tasks. The results obtained are consistent with this hypothesis and question the state of cognitive assessment in the elderly population and particularly in the evaluation of the pre-dementia. Therefore it seems important to provide a non-threatening test environment to limit all the effects of the stereotype threat on cognitive performance.
References
Mazerolle, M., Régner, I., Barber, S. J., Paccalin, M., Miazola, A.-C., Huguet, P., & Rigalleau, F. (2016). Negative aging stereotypes impair performance on brief cognitive tests used to screen for predementia. Journals of Gerontology Series B: Psychological Sciences and Social Sciences. doi:10.1093/geronb/gbw083
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I.,…& Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695-699.
Folstein M.F., Folstein S.E., & McHugh PR . (1975). Mini Mental State. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198.
