Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T14:28:12.520Z Has data issue: false hasContentIssue false
  • English
  • Français

Expressive Suppression Depletes Executive Functioning in Older Adulthood

Published online by Cambridge University Press:  13 March 2017

E. I. Franchow Open the ORCID record for E. I. Franchow [Opens in a new window]  and
Yana Suchy Open the ORCID record for Yana Suchy [Opens in a new window]
E. I. Franchow*
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Yana Suchy
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
*
Correspondence and reprint requests to: Emilie I. Franchow, Department of Psychology, 380 S. 1530 E. Room 502, Salt Lake City, UT, 84112. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Accurate detection of executive dysfunction in neuropsychological assessments is complicated by the fact that executive functioning (EF) is vulnerable to temporary disruption (i.e., lapses), with more frequent lapses in older adulthood. Effortful regulation of affect (i.e., expressive suppression) is a well-known source of executive lapses in younger adults, but the generalizability of this depleting effect to older adults is unknown. The purpose of this study was to (1) determine whether EF is subject to depletion via expressive suppression and (2) to examine whether this effect is unique to EF, or whether it also applies to lower-order component processes in older adults. Methods: Ninety-seven non-demented, community-dwelling older adults were randomly assigned to either an expressive suppression group or control group. We compared performance of the groups on a battery of tests measuring EF and component processes both before and after exposure to emotionally evocative stimuli. Results: Consistent with the hypothesized depletion effect, suppressing participants showed an attenuated practice effect on post-manipulation EF relative to controls, while performance on lower-order component processes was unaffected by suppression. Conclusions: These results suggest that depletion contributes to executive lapses in older adulthood. (JINS, 2017, 23, 341–351)

Keywords

Affect suppressionEmotional suppressionEmotion regulationExecutive controlDepletionCognitive aging
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 23 , Issue 4 , April 2017 , pp. 341 - 351
Copyright
Copyright © The International Neuropsychological Society 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baudouin, A., Clarys, D., Vanneste, S., & Isingrini, M. (2009). Executive functioning and processing speed in age-related differences in memory: Contribution of a coding task. Brain and Cognition, 71(3), 240–245. doi: 10.1016/j.bandc.2009.08.007 CrossRefGoogle ScholarPubMed
Baumeister, R.F., & Alquist, J.L. (2009). Is there a downside to good self-control? Self and Identity, 8(2-3), 115–130. doi: 10.1080/15298860802501474 CrossRefGoogle Scholar
Baumeister, R.F., Bratslavsky, E., Muraven, M., & Tice, D.M. (1998). Ego depletion: Is the active self a limited resource? Journal of Personality and Social Psychology, 74(5), 1252–1265. doi: 10.1037/0022-3514.74.5.1252 CrossRefGoogle Scholar
Bell-McGinty, S., Podell, K., Franzen, M., Baird, A.D., & Williams, M.J. (2002). Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry, 17(9), 828–834.CrossRefGoogle ScholarPubMed
Benitez, A., & Gunstad, J. (2012). Poor sleep quality diminishes cognitive functioning independent of depression and anxiety in healthy young adults. The Clinical Neuropsychologist, 26(2), 214–223. doi: 10.1080/13854046.2012.658439 CrossRefGoogle ScholarPubMed
Bielak, A.A.M., Hultsch, D.F., Strauss, E., MacDonald, S.W.S., & Hunter, M.A. (2010). Intraindividual variability in reaction time predicts cognitive outcomes 5 years later. Neuropsychology, 24(6), 731–741. doi: 10.1037/a0019802 CrossRefGoogle ScholarPubMed
Brown, G.G., Rahill, A.A., Gorell, J.M., McDonald, C., Brown, S.J., Sillanpaa, M., & Shults, C. (1999). Validity of the Dementia Rating Scale in assessing cognitive function in Parkinson’s disease. Journal of Geriatric Psychiatry and Neurology, 12(4), 180–188.CrossRefGoogle ScholarPubMed
Bruce, M.L., Seeman, T.E., Merrill, S.S., & Blazer, D.G. (1994). The impact of depressive symptomatology on physical disability: MacArthur Studies of Successful Aging. American Journal of Public Health, 84(11), 1796–1799. doi: 10.2105/AJPH.84.11.1796 CrossRefGoogle ScholarPubMed
Carstensen, L.L., Pasupathi, M., Mayr, U., & Nesselroade, J.R. (2000). Emotional experience in everyday life across the adult life span. Journal of Personality and Social Psychology, 79(4), 644–655.CrossRefGoogle ScholarPubMed
Charles, S.T., Reynolds, C.A., & Gatz, M. (2001). Age-related differences and change in positive and negative affect over 23 years. Journal of Personality and Social Psychology, 80(1), 136–151. doi: 10.1037/0022-3514.80.1.136 CrossRefGoogle ScholarPubMed
Chaytor, N., & Schmitter-Edgecombe, M. (2003). The ecological validity of neuropsychological tests: A review of the literature on everyday cognitive skills. Neuropsychology Review, 13(4), 181–197. doi: 10.1023/B:NERV.0000009483.91468.fb CrossRefGoogle ScholarPubMed
Cummings, J.L., & Miller, B.L. (2007). Conceptual and clinical aspects of the frontal lobes. In B.L. Miller & J.L. Cummings (Eds.), The human frontal lobes: Functions and disorders (2nd ed, pp. 12–21). New York, NY: Guilford Press.Google Scholar
Dawson, D.R., Levine, B., Schwartz, M., & Stuss, D.T. (2000). Quality of life following traumatic brain injury: A prospective study. Brain and Cognition, 44(1), 35–39. doi: 10.1006/brcg.1999.1208 Google Scholar
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Delis Kaplan Executive Function System - Examiner’s Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Delis, D.C., Kramer, J.H., Kaplan, E., & Holdnack, J. (2004). Reliability and validity of the Delis-Kaplan Executive Function System: An update. Journal of the International Neuropsychological Society, JINS, 10(2), 301–303. doi: 10.1017/S1355617704102191 CrossRefGoogle ScholarPubMed
Demaree, H.A., Schmeichel, B.J., Robinson, J.L., & Everhart, D.E. (2004). Behavioural, affective, and physiological effects of negative and positive emotional exaggeration. Cognition and Emotion, 18(8), 1079–1097.CrossRefGoogle Scholar
Engelborghs, S., Maertens, K., Nagels, G., Vloeberghs, E., Mariën, P., Symons, A., & De Deyn, P.P. (2005). Neuropsychiatric symptoms of dementia: Cross-sectional analysis from a prospective, longitudinal Belgian study. International Journal of Geriatric Psychiatry, 20(11), 1028–1037.CrossRefGoogle ScholarPubMed
Ewert, S., & Kominski, R. (2014). Measuring alternative educational credentials: 2012. Current Population Reports Series P70-138. Washington, DC: US Census Bureau.Google Scholar
Franchow, E.I., & Suchy, Y. (2015). Naturally-occurring expressive suppression in daily life depletes executive functioning. Emotion, 15(1), 78–89.CrossRefGoogle ScholarPubMed
Gallo, J.J., Rabins, P.V., Lyketsos, C.G., Tien, A.Y., & Anthony, J.C. (1997). Depression without sadness: functional outcomes of nondysphoric depression in later life. Journal of the American Geriatrics Society, 45(5), 570–578. doi: 10.1111/j.1532-5415.1997.tb03089.x CrossRefGoogle ScholarPubMed
Gamaldo, A.A., An, Y., Allaire, J.C., Kitner–Triolo, M.H., & Zonderman, A.B. (2012). Variability in performance: Identifying early signs of future cognitive impairment. Neuropsychology, 26(4), 534–540. doi: 10.1037/a0028686 CrossRefGoogle ScholarPubMed
Goldberg, E., & Bilder, R.M. Jr. (1987). The frontal lobes and hierarchical organization of cognitive control. In E. Perecman (Ed.), The frontal lobes revisited (pp. 159–187). New York, NY: The IRBN Press.Google Scholar
Gross, J.J. (1998). Antecedent- and response-focused emotion regulation: Divergent consequences for experience, expression, and physiology. Journal of Personality and Social Psychology, 74(1), 224–237. doi: 10.1037/0022-3514.74.1.224 CrossRefGoogle ScholarPubMed
Gross, J.J. (2007). Handbook of emotion regulation. New York, NY: Guilford Press.Google Scholar
Gross, J.J., & Levenson, R.W. (1995). Emotion elicitation using films. Cognition and Emotion, 9(1), 87–108. doi: 10.1080/02699939508408966 CrossRefGoogle Scholar
Gunstad, J., Spitznagel, M.B., Luyster, F., Cohen, R.A., & Paul, R.H. (2007). Handedness and cognition across the healthy lifespan. International Journal of Neuroscience, 117(4), 477–485. doi: 10.1080/00207450600773483 CrossRefGoogle ScholarPubMed
Heaton, R.K., Temkin, N., Dikmen, S., Avitable, N., Taylor, M.J., Marcotte, T.D., & Grant, I. (2001). Detecting change: A comparison of three neuropsychological methods, using normal and clinical samples. Archives of Clinical Neuropsychology, 16(1), 75–91. doi: 10.1016/S0887-6177(99)00062-1 CrossRefGoogle Scholar
Hedden, T., & Gabrieli, J.D.E. (2004). Insights into the ageing mind: A view from cognitive neuroscience. Nature Reviews. Neuroscience, 5(2), 87–96.CrossRefGoogle ScholarPubMed
Hubert, W., Möller, M., & de Jong-Meyer, R. (1993). Film-induced amusement changes in saliva cortisol levels. Psychoneuroendocrinology, 18(4), 265–272. doi: http://dx.doi.org/10.1016/0306-4530(93)90023-E CrossRefGoogle ScholarPubMed
Hultsch, D.F., MacDonald, S.W.S., Hunter, M.A., Levy-Bencheton, J., & Strauss, E. (2000). Intraindividual variability in cognitive performance in older adults: Comparison of adults with mild dementia, adults with arthritis, and healthy adults. Neuropsychology, 14(4), 588–598.CrossRefGoogle ScholarPubMed
Insel, K., Morrow, D., Brewer, B., & Figueredo, A. (2006). Executive function, working memory, and medication adherence among older adults. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 61B(2), P102–P107. doi: 10.1093/geronb/61.2.P102 CrossRefGoogle Scholar
Inzlicht, M., & Gutsell, J.N. (2007). Running on empty: Neural signals for self-control failure. Psychological Science, 18(11), 933–937. doi: 10.1111/j.1467-9280.2007.02004.x CrossRefGoogle ScholarPubMed
John, O.P., & Gross, J.J. (2004). Healthy and unhealthy emotion regulation: Personality processes, individual differences, and life span development. Journal of Personality, 72(6), 1301–1333.CrossRefGoogle ScholarPubMed
Johns, M., Inzlicht, M., & Schmader, T. (2008). Stereotype threat and executive resource depletion: Examining the influence of emotion regulation. Journal of Experimental Psychology: General, 137(4), 691–705. doi: 10.1037/a0013834 CrossRefGoogle ScholarPubMed
Jongsma, M.L.A., Postma, S.A.E., Souren, P., Arns, M., Gordon, E., Vissers, K., & van Goor, H. (2011). Neurodegenerative properties of chronic pain: Cognitive decline in patients with chronic pancreatitis. PLos One, 6(8) doi: 10.1371/journal.pone.0023363 CrossRefGoogle ScholarPubMed
Jurica, P.J., Leitten, C.L., & Mattis, S. (2001). DRS-2: Dementia Rating Scale-2, Professional Manual. Lutz, FL: PAR.Google Scholar
Karp, J.F., Reynolds, C.F. III, Butters, M.A., Dew, M.A., Mazumdar, S., Begley, A.E., & Weiner, D.K. (2006). The relationship between pain and mental flexibility in older adult pain clinic patients. Pain Medicine, 7(5), 444–452. doi: 10.1111/j.1526-4637.2006.00212.x CrossRefGoogle ScholarPubMed
Kovner, R., Lazar, J.W., Lesser, M., Perecman, E., Kaplan, M.H., Hainline, B., & Napolitano, B. (1992). Use of the Dementia Rating Scale as a test for neuropsychological dysfunction in HIV-positive iv drug abusers. Journal of Substance Abuse Treatment, 9(2), 133–137.CrossRefGoogle Scholar
Krampe, R.T. (2002). Aging, expertise and fine motor movement. Neuroscience & Biobehavioral Reviews, 26(7), 769–776. doi: http://dx.doi.org/10.1016/S0149-7634(02)00064-7 CrossRefGoogle ScholarPubMed
Kraybill, M.L., & Suchy, Y. (2011). Executive functioning, motor programming, and functional independence: Accounting for variance, people, and time. The Clinical Neuropsychologist, 25(2), 210–223. doi: 10.1080/13854046.2010.542489 CrossRefGoogle ScholarPubMed
Kraybill, M.L., Thorgusen, S.R., & Suchy, Y. (2013). The Push-Turn-Taptap task outperforms measures of executive functioning in predicting declines in functionality: Evidence-based approach to test validation. The Clinical Neuropsychologist, 27(2), 238–255. doi: 10.1080/13854046.2012.735702 CrossRefGoogle ScholarPubMed
Lang, F.R., Staudinger, U.M., & Carstensen, L.L. (1998). Perspectives on socioemotional selectivity in late life: How personality and social context do (and do not) make a difference. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 53B(1), P21–P30.CrossRefGoogle Scholar
Levine, B., Dawson, D., Boutet, I., Schwartz, M.L., & Stuss, D.T. (2000). Assessment of strategic self-regulation in traumatic brain injury: Its relationship to injury severity and psychosocial outcome. Neuropsychology, 14(4), 491–500. doi: 10.1037/0894-4105.14.4.491 CrossRefGoogle ScholarPubMed
Levy, J.A., & Chelune, G.J. (2007). Cognitive-behavioral profiles of neurodegenerative dementias: Beyond Alzheimer’s disease. Journal of Geriatric Psychiatry and Neurology, 20(4), 227–238. doi: 10.1177/0891988707308806 CrossRefGoogle ScholarPubMed
Lezak, M.D., Howieson, D.B., Bigler, E.D., & Tranel, D. (2013). Neuropsychological assessment (5th ed.), Oxford, UK: Oxford University Press.Google Scholar
Lindau, M., Almkvist, O., Kushi, J., Boone, K., Johansson, S.E., Wahlund, L.O., & Miller, B.L. (2000). First symptoms-frontotemporal dementia versus Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 11(5), 286–293. doi: 10.1159/000017251 CrossRefGoogle ScholarPubMed
Luria, A.R., & Haigh, B. (1992). Neuropsychology: Its sources, principles, and prospects. In F.G. Worden, J.P. Swazey, G. Adelman, F.G. Worden, J.P. Swazey, & G. Adelman (Eds.), The neurosciences: Paths of discovery, 1 (pp. 335–361). Cambridge, MA: Birkhäuser.Google Scholar
Martin, E.A., & Kerns, J.G. (2011). The influence of positive mood on different aspects of cognitive control. Cognition and Emotion, 25(2), 265–279. doi: 10.1080/02699931.2010.491652 CrossRefGoogle ScholarPubMed
Mayr, U. (2001). Age differences in the selection of mental sets: The role of inhibition, stimulus ambiguity, and response-set overlap. Psychology and Aging, 16(1), 96–109. doi: 10.1037/0882-7974.16.1.96 CrossRefGoogle ScholarPubMed
McDaniel, W.F., & McLaughlin, T. (2000). Further support for using the Dementia Rating Scale in the assessment of neuro-cognitive functions of individuals with mental retardation. The Clinical Neuropsychologist, 14(1), 72–75.CrossRefGoogle ScholarPubMed
Meiran, N., & Gotler, A. (2001). modelling cognitive control in task switching and ageing. European Journal of Cognitive Psychology, 13(1-2), 165–186. doi: 10.1080/09541440042000269 CrossRefGoogle Scholar
Mitchell, M., & Miller, L.S. (2008). Prediction of functional status in older adults: The ecological validity of four Delis–Kaplan Executive Function System tests. Journal of Clinical and Experimental Neuropsychology, 30(6), 683–690. doi: 10.1080/13803390701679893 CrossRefGoogle ScholarPubMed
Mitrushina, M., & Satz, P. (1991). Effect of repeated administration of a neuropsychological battery in the elderly. Journal of Clinical Psychology, 47(6), 790–801. doi: 10.1002/1097-4679(199111)47:6<790::AID-JCLP2270470610>3.0.CO;2-C 3.0.CO;2-C>CrossRefGoogle ScholarPubMed
Mitsis, E.M. (2004). The construct validity of executive functions in normal adults and in adults with mild cognitive impairment. (64), ProQuest Information & Learning, US. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2004-99004-428&site=ehost-live.Google Scholar
Muraven, M., Tice, D.M., & Baumeister, R.F. (1998). Self-control as a limited resource: Regulatory depletion patterns. Journal of Clinical and Experimental Neuropsychology, 74(3), 774–789. doi: 10.1037/0022-3514.74.3.774 Google ScholarPubMed
Nes, L.S., Roach, A.R., & Segerstrom, S.C. (2009). Executive functions, self-regulation, and chronic pain: A review. Annals of Behavioral Medicine, 37(2), 173–183. doi: 10.1007/s12160-009-9096-5 Google Scholar
Niermeyer, M.A., Franchow, E.I., & Suchy, Y. (2016). Reported expressive suppression in daily life is associated with slower action planning. Journal of the International Neuropsychological Society: JINS, 22(6), 671.CrossRefGoogle ScholarPubMed
Oaksford, M., Morris, F., Grainger, B., & Williams, J.M.G. (1996). Mood, reasoning, and central executive processes. Journal of Experimental Psychology: Learning, Memory, and Cognition, 22(2), 476–492. doi: 10.1037/0278-7393.22.2.476 Google Scholar
Ohira, H., Nomura, M., Ichikawa, N., Isowa, T., Iidaka, T., Sato, A., & Yamada, J. (2006). Association of neural and physiological responses during voluntary emotion suppression. Neuroimage, 29, 721–733.CrossRefGoogle ScholarPubMed
Parasuraman, R., & Giambra, L. (1991). Skill development in vigilance: Effects of event rate and age. Psychology and Aging, 6(2), 155–169. doi: 10.1037/0882-7974.6.2.155CrossRefGoogle ScholarPubMed
Pietrzak, R.H., Snyder, P.J., Jackson, C.E., Olver, J., Norman, T., Piskulic, D., & Maruff, P. (2009). Stability of cognitive impairment in chronic schizophrenia over brief and intermediate re-test intervals. Human Psychopharmacology: Clinical and Experimental, 24(2), 113–121. doi: 10.1002/hup.998 CrossRefGoogle ScholarPubMed
Razani, J., Casas, R., Wong, J.T., Lu, P., Alessi, C., & Josephson, K. (2007). Relationship between executive functioning and activities of daily living in patients with relatively mild dementia. Applied Neuropsychology, 14(3), 208–214. doi: 10.1080/09084280701509125 CrossRefGoogle ScholarPubMed
Reimers, S., & Maylor, E.A. (2005). Task switching across the life span: Effects of age on general and specific switch costs. Developmental Psychology, 41(4), 661–671. doi: 10.1037/0012-1649.41.4.661 CrossRefGoogle ScholarPubMed
Riediger, M., Wrzus, C., Klipker, K., Müller, V., Schmiedek, F., & Wagner, G.G. (2014). Outside of the laboratory: Associations of working-memory performance with psychological and physiological arousal vary with age. Psychology and Aging, 29(1), 103–114. doi: 10.1037/a0035766 CrossRefGoogle ScholarPubMed
Royall, D.R., Palmer, R., Chiodo, L.K., & Polk, M.J. (2004). Declining executive control in normal aging predicts change in functional status: The Freedom House Study. Journal of the American Geriatrics Society, 52(3), 346–352. doi: 10.1111/j.1532-5415.2004.52104.x CrossRefGoogle ScholarPubMed
Royall, D.R., Palmer, R., Chiodo, L.K., & Polk, M.J. (2005). Executive control mediates memory’s association with change in instrumental activities of daily living: The Freedom House Study. Journal of the American Geriatrics Society, 53(1), 11–17. doi: 10.1111/j.1532-5415.2005.53004.x CrossRefGoogle ScholarPubMed
Ruff, R. (2005). Two decades of advances in understanding of mild traumatic brain injury. The Journal of Head Trauma Rehabilitation, 20(1), 5–18. doi: 10.1097/00001199-200501000-00003 CrossRefGoogle ScholarPubMed
Salthouse, T.A. (2004). What and when of cognitive aging. Current Directions in Psychological Science, 13(4), 140–144.CrossRefGoogle Scholar
Schmeichel, B.J. (2007). Attention control, memory updating, and emotion regulation temporarily reduce the capacity for executive control. Journal of Experimental Psychology: General, 136(2), 241–255. doi: 10.1037/0096-3445.136.2.241 CrossRefGoogle ScholarPubMed
Schmeichel, B.J., Vohs, K.D., & Baumeister, R.F. (2003). Intellectual performance and ego depletion: Role of the self in logical reasoning and other information processing. Journal of Personality and Social Psychology, 85(1), 33–46. doi: 10.1037/0022-3514.85.1.33 CrossRefGoogle ScholarPubMed
Schoenberg, M.R., & Duff, K. (2011). Dementias and mild cognitive impairment in adults. In M.R. Schoenberg, J.G. Scott, M.R. Schoenberg & J.G. Scott (Eds.), The little black book of neuropsychology: A syndrome-based approach (pp. 357–403). New York, NY: Springer Science + Business Media.CrossRefGoogle Scholar
Stuss, D.T., Picton, T.W., & Alexander, M.P. (2001). Consciousness, self-awareness, and the frontal lobes. In S.P. Salloway, P.F. Malloy & J.D. Duffy (Eds.), The frontal lobes and neuropsychiatric illness (pp. 101–109). Arlington, VA: American Psychiatric Publishing, Inc.Google Scholar
Suchy, Y., Kraybill, M.L., & Franchow, E (2011). Practice effect and beyond: Reaction to novelty as an independent predictor of cognitive decline among older adults. Journal of the International Neuropsychological Society: JINS, 17(1), 101–111. doi: 10.1017/S135561771000130X CrossRefGoogle ScholarPubMed
Suchy, Y. (2015). Executive functioning: A comprehensive guide for clinical practice. New York, NY: Oxford University Press.Google Scholar
Sultzer, D.L., Levin, H.S., Mahler, M.E., High, W.M., & Cummings, J.L. (1993). A comparsion of psychiatric symptoms in vascular dementia and Alzheimer’s disease. The American Journal of Psychiatry, 150(12), 1806–1812.Google Scholar
Sutter, C., Zöllig, J., Allemand, M., & Martin, M. (2012). Sleep quality and cognitive function in healthy old age: The moderating role of subclinical depression. Neuropsychology, 26(6), 768–775. doi: 10.1037/a0030033 CrossRefGoogle ScholarPubMed
Szaflarski, J.P., Binder, J.R., Possing, E.T., McKiernan, K.A., Ward, B.D., & Hammeke, T.A. (2002). Language lateralization in left-handed and ambidextrous people: fMRI data. Neurology, 59(2), 238–244.CrossRefGoogle ScholarPubMed
Wegner, D.M., Shortt, J.W., Blake, A.W., & Page, M.S. (1990). The suppression of exciting thoughts. Journal of Personality and Social Psychology, 58(3), 409–418. doi:10.1037/0022-3514.58.3.409 CrossRefGoogle ScholarPubMed
West, R. (2001). The transient nature of executive control processes in younger and older adults. European Journal of Cognitive Psychology, 13(1-2), 91–105. doi: 10.1080/09541440042000232 CrossRefGoogle Scholar
West, R., Murphy, K.J., Armilio, M.L., Craik, F.I.M., & Stuss, D.T. (2002). Lapses of intention and performance variability reveal age-related increases in fluctuations of executive control. Brain and Cognition, 49(3), 402–419. doi: http://dx.doi.org/10.1006/brcg.2001.1507 CrossRefGoogle ScholarPubMed
Yesavage, J.A. (1988). Geriatric depression scale. Psychopharmacology Bulletin, 24, 709–711.Google ScholarPubMed