The Study of Healthy Aging
& Applied Research Programs
Clemson University
Everyday Functioning
Updated January 2024. *Indicates student; **Indicates postdoctoral fellow
*Tian J., *Tan, S. C., Sardina, A. L., Gamaldo, A. A., & Ross, L. A. (Under review at Journal of Transport and Health since February 2023). Correlates of modes of transportation utilized among older adults residing in subsidized housing: A preliminary study.
Overview: Still under review
†Stephan, A. T., *McVey, A., *Wolf, A. V., Sprague, B. N., Phillips, C. B., & Ross, L. A. (Under review at Aging and Mental Health since February 2023). Differential associations of depressive symptoms on cognitive status by living situation in healthy older adults.
Overview: Still under review
†Stephan, A. T., *McVey, A., *Steele, T., *Cooper, K., Phillips, C. B., & Ross, L. A. (2023). Older adults’ perceptions of cognitive, physical, and exergaming training: A mixed methods investigation of a four-armed randomized controlled pilot trial.
Overview: The present study investigates older adults’ adherence to a novel mobile app designed to conveniently and cost-effectively monitor IADL function. We also examine participants’ acceptability of the app, including their overall satisfaction, perceived ease of use, benefits and limitations, and suggestions for improvement.
*Tian, J., Ross, L. A., Mogle, J., & Anstey, K. J. (Under review at Accident Analysis and Prevention since January 2023). Evaluation and Modification of the Multifactorial Model of Driving Safety: An Empirical Assessment using the ACTIVE Study
Overview: Still under review
Pope, C. N., *Wheeler, K. M., †Bell. T. R., Carroll, B. E., Ross, L. A., Crowe, M., Black, S. R., Clay, O. J., & Ball, K. K. (2023). Social determinants of health moderate the associations between processing speed and driving mobility over 10 years: An analysis of the ACTIVE study.
Overview: This study characterized the longitudinal association between processing speed and driving mobility, and how it varied by race and SDoH. Methods: Using data from the control arm of the Advanced Cognitive Training in Vital Elderly study (n = 581, 24.5% Black), multilevel models examined longitudinal associations between processing speed and driving mobility outcomes (driving space, exposure, and difficulty). Race and SDoH moderations were explored.
*Freed, S. A., Ross, L. A., Mogle, J., Gamaldo, A. A., & Zhang, Y. (2022). Driver license renewal requirements predict driving mobility among older drivers with health-related travel difficulties.
Overview: The present study examined the association between license renewal requirements and driving mobility in a national sample of 89,757 older adults aged 62 and older in the United States (M age = 71.57, standard deviation age = 7.48). Using generalized estimating equations, the associations between two driver licensing requirements (in-person renewal and length of renewal cycle) and two indicators of driving mobility (driving status and annual driving mileage) were examined.
*Freed, S. A., †Sprague, B. N., & Ross, L. A. (2022). Does the association between objective and subjective memory vary by age among healthy older adults. Aging, Neuropsychology and Cognition. DOI: 10.1080/13825585.2022.2143471
Overview: The current study examined age-varying associations between subjective and objective memory in a cross-sectional sample of healthy older adults from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (N = 2,496). Time varying effects modeling (TVEM) models the association between variables as a function of time-varying metrics including age without imposing linear assumptions. TVEM was used to examine relationship magnitude fluctuations between subjective and objective memory across ages 65 to 85.
†Bell, T. R., †Sprague, B. N., & Ross, L. A. (in press). Longitudinal associations of incident pain with cognitive decline in community-dwelling older adults. Psychology & Aging.
Byrne, K. A., *Anaraky, R. G., Dye, C., Ross, L. A., Madathil, K. C., Knijnenburg, B., & Levkoff, S. (2021). Examining rural and racial disparities in the relationship between loneliness and social technology use among older adults. Frontiers in Public Health, 9(723925). DOI: 10.3389/fpubh.2021.723925
Overview: Findings of this study demonstrated that rurality, but not race, moderated the relationship between loneliness and social technology use among older adults. Additionally, those in rural environments tended to use social technology less than those in suburban environments.
Ball, K. K., Clay, O. J., Edwards, J. D., Fausto, B., Wheeler, K. M., Felix, C., & Ross, L. A. (2021). Indicators of crash risk in older adults: A longitudinal analysis from the ACTIVE study. Journal of Aging and Health. doi: 10.1177/08982643211031346
Overview: This study found that older age, male gender, site location, and worse scores on speed of processing predicted state-reported crashes across ten years.
*Chamberlain, J. D., Sprague, B. N., & Ross, L. A. (2022). Age- and time-varying associations between subjective health and episodic memory in older adults. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences
Overview: This study used time-varying effects modeling (TVEM) to examine how the association between subjective health and episodic memory differs across age in older adults.
Overview: This study examined the predictions of Strength and Vulnerability Integration theory, which posits that higher levels of chronic stress will attenuate favorable age gradients for multiple indices of well-being. The study found that older age is not significantly associated with well-being in conditions of high levels of chronic stress.
*Freed, S. A., Ross, L. A., Gamaldo, A. A., & Stavrinos, D. (2021) Use of multilevel modeling to examine variability of distracted driving behavior in naturalistic driving studies. Accident Analysis & Prevention. doi: 10.1016/j.aap.2021.105968
Overview: This study demonstrates the utility of examining within-person variability in a naturalistic driving dataset of 68 older drivers across two weeks. To our knowledge, this is the first study to use multilevel modeling to quantify variability in distracted driving behavior in a naturalistic dataset for older drivers.
Overview: This study examined satisfaction across life domains (condition of the home, city of residence, daily life/leisure, family life, current financial situation, total household income, health, and life as a whole) among Black adults. This study also examines the association between satisfaction in each domain and sociodemographic, personality, and mental/physical health measures. Results suggest that levels of life satisfaction vary across domains and that life satisfaction may serve as a source of resiliency for Black adults.
Gamaldo, A. A., *Tan, S. C., Sardina, A. L., *Henzi, C., *Guest, R., Ross, L. A., *Willingham, K., Zonderman, A. B., Andel, R. A. (2020). Older Black adults’ satisfaction and anxiety levels after completing alternative versus traditional cognitive batteries. Journals of Gerontology, Series B: Psychological Sciences, 75(7), 1462-1474. DOI: 10.1093/geronb/gby095
Overview: This study examined anxiety and satisfaction with computer-based and traditional paper-and-pencil based neuropsychological testing batteries among black colder adults. Results indicated that participants were more satisfied and less anxious using the computer batteries in comparison to the paper-and-pencil battery.
Overview: This paper examined the relationship between baseline driving status and lifespace across five years and whether this relationship differed by residential status. Results indicated that non-drivers had smaller mean lifespace than drivers across five years, and rates of lifespace declines did not differ between drivers and non-drivers. Non-drivers at baseline residing in low population density areas had smaller lifespace than non-drivers in high population density areas. The findings suggest that residential context plays a role in older adults' travel behavior and choices.
Overview: This paper examined cross-sectional relationships between physical and cognitive function in older adults using a novel statistical technique called time-varying effects modeling (TVEM). Briana and her colleagues found that simple physical function was a stronger predictor of processing speed, memory, and reasoning for the oldest-old, and complex physical function generally was a stronger predictor for the young-old and oldest old. This demonstrates that age plays a critical role in how relationships between physical and cognitive function couple across the older adulthood continuum.
Overview: This paper examines teen drivers in the Senior and Adolescent Naturalistic Driving Study (SANDS). Worse self-reported executive function was associated with higher odds of self-reported problematic driving outcomes. However, there was no association between performance-based executive function meaasures and self-reported problematic driving outcomes. The authors discuss the application of research findings to potential screening tools for adolescent drivers.
Overview: The taxonomy, terms, and definitions constitute suggestions that, in the view of its sponsoring committee, will facilitate communication and promote best practice among a host of disciplines and professional organizations committed to safe, independent, and dignified options for seniors to remain mobile
within their communities. It is anticipated that this resource will be revised and updated as
needed to reflect the dynamic and evolving set of issues that confront practitioners in this area.
Overview: This paper examines teens and older drivers in the Senior and Adolescent Naturalistic Driving (SANDS) study. In teens, higher levels of openness and conscientiousness and lower levels of agreeableness were associated with greater frequency of texting and interacting with a phone while driving. In older adults, greater extraversion was associated with greater talking and interacting with a phone while driving. Results suggest that specific personality traits associated with distracted driving are different across age groups. Implications for targeted interventions are discussed.
Overview: Baseline cognitive function and visual acuity were positively related to changes in driving mobility across five years. Changes in general health and changes in physical function were positively associated with changes in driving mobility across five years. Patterns of associations varied depending on the specific physical function measure and mobility outcome. Results highlight the time-varying nature of the relationships between physical function and driving mobility.
Anstey, K. J., Eramugolla, R., Ross, L. A., Lautenschlager, N. T., & Wood, J. (2016). Road safety in an ageing population: Risk factors, assessment, interventions and future directions. International Psychogeriatrics, 28, 349-356. DOI:10.1017/S1041610216000053. PMCID:PMC26888735.
Overview: This editorial reviews risk factors of driving safety in older adults, including cognitive and visual function, as well as interventions targeting these risk factors. Assessments of driving performed by physicians present issues with patient willingness to disclose driving difficulties and validity of physician assessment. Evidence-based screening of driving ability that is inexpensive, culturally appropriate, and easily administered by providers of different backgrounds is needed.
Overview: Factor analysis of executive function measures revealed two factors that require distinct executive processes. Greater cortical thickness in the Cingulo-Opercular Network predicts better performance on the Sustained Executive Control factor. Greater cortical thickness in the Frontoparietal Network predicts better performance on the Complex Attention Control factor. Results suggest that distinct brain networks predict different executive processes.
Overview: Older age and poorer visual speed of processing, but not CD4+ T lymphocyte count or viral load, were related to poorer driving performance. Mixed findings were observed between driving performance and cognitive function on self-reported driving habits of participants.
Overview: Findings suggest that there are not unique cognitive subtypes in HIV, but rather a subset of individuals who exhibit globally normal performance and those with below average performance. Older age and the related cardiovascular comorbidities of both aging and HIV medications may be key factors in explaining variability in neurocognitive functioning in this population.
Overview: Computer experience was related to cognitive performance, regardless of computerized or paper and pencil measure.
Overview: Self-report driving was not a reliable indicator of driving competency.
Overview: Females experienced more depression across all ages. Depression also did not decline with age as expected.
Overview: Dynopta is a longitudinal study of ageing. It provides the prevalence of disease and disability, evaluates health and social policy, and generates projections of expected health and morbidity.
Overview: UFOV test significantly predicted at fault crashes and insurance claims among older adults.
Overview: Age-based testing was significantly associated with lower rates of driving. This was similar for older adults with and without cognitive and visual impairments.
Overview: This chapter provides an overview of the physiology of aging, cognitive changes found during aging and how these factors impact everyday functioning in older adults. Additionally, potential interventions and future research directions are discussed.
Overview: DYNOPTA investigates ways to optimize ageing outcomes using an interdisciplinary approach, as well as provides cross-national analyses.
Overview: Cancer treatment with chemotherapy was associated with decreased performance of processing speed. This then has social, health, and economic implications on older cancer survivors.
Overview: Investigates the predictors of driving status across a large sample of older adults, their relative cognitive and visual health, as well as comparisons of driving status across three countries.
Overview: Structural Equation Modeling (SEM) is used to investigate the relationships between age, sensory function, and cognitive functioning in a sample of older adults.
Overview: This paper examines the predictors of driving mobility trajectories across a five year period.
Overview: Older age, cognitive decline, poor near visual acuity, health, depressive symptoms, and being a non-driver were associated with 3-year mortality.
Overview: Adults who were older, female, White, had poor lower limb mobility, and had better memory were more likely to have a greater number of falls.
Overview: Older age, poorer balance, slower speed of processing, and poorer instrumental functional performance were all predictors of driving cessation over a three year period.
Overview: Slower speed in performing instrumental activities of daily living may be an important factor in detecting mild cognitive impairment.
Overview: Older age, poorer health, poorer physical functioning, and slower speed of processing were predictors of driving cessation over a five year period. Poorer visual acuity also increased risk of cessation, but to a lesser extent. Despite findings from other studies, gender had no relationship with risk of driving cessation.
Overview: Depressive symptoms predicted lower self-reported cognitive ability in adults with HIV. Additionally, lower self-reported cognitive ability was related to poorer cognitive performance.
Overview: This paper examines correlates of physical activity in older adults including medical conditions, depressive symptoms, education age, social network size and activity, and vision.
Overview: This paper provides normative data for the Useful Field of View test and the impact of age, education, mental status, vision, and health on test performance.