Surprise Findings from Tower of Hanoi Research on Executive Cognitive Function in Older Adults: Assess, Intervene, or Both?

2.50
Hdl Handle:
http://hdl.handle.net/10755/243490
Category:
Full-text
Type:
Presentation
Title:
Surprise Findings from Tower of Hanoi Research on Executive Cognitive Function in Older Adults: Assess, Intervene, or Both?
Author(s):
Mildren, Whitney G.; Cazzell, Mary A.; Holland, James Daniel
Lead Author STTI Affiliation:
Delta Theta (Region 6)
Author Details:
Mildren, Whitney G., RN, BSN, wmildren@uta.edu; Cazzell, Mary A., RN, PhD; Holland, James D., MA;
Abstract:
Purpose: The purpose was to determine feasibility, reliability, and item difficulty of the 22-task Tower of Hanoi (TOH), an executive cognitive function (ECF) puzzle game, in adults > 65 years. Neuroimaging research has documented prefrontal cortex (PFC) changes in aging: deficits in abstract thinking, problem solving, and loss of inhibitory control over irrelevant information. The 22-task TOH, a 4-disk transfer game across 3 vertical pegs, has never been administered to or scored on older adults nor has TOH psychometrics been established in this population.

'Methods: In this quantitative descriptive design, a convenience sample of 50 cognitively-intact independent-living older adults (> 65 years) completed 22 TOH tasks, 22 different start and end configurations. Eligibility included a pre-screening score of >26 score on the Montreal Cognitive Assessment. Rasch analysis was completed on: (1) item-difficulty estimation, (2) item characteristic curves, (3) item-and-person-fit statistics of predicted functioning, and (4) test information function on precision of TOH in differentiating ability levels. 22 tasks were scored for correct/incorrect, total moves, number of moves beyond minimal moves, and gender differences. Cronbach's alpha was obtained for reliability.

'Results: All participants completed 22 tasks. Older adults demonstrated a lower ability to solve even the easiest tasks. Most TOH items were more difficult than the demonstrated problem-solving skills needed to achieve expected number of moves. TOH reliability alpha was 0.69. Approximately 21% of all 22-items were performed correctly/participant. Females completed significantly more correct items than males (p<0.001). All incorrect moves were analyzed and number of extra moves beyond correct solution ranged from 2.8 to 11.4.

'Conclusion: Despite TOH's level of difficulty, participants reported increased self-confidence, improved perception of cognitive abilities, and greater motivation to further practice on TOH. This study introduces TOH as both a cognitive assessment tool and intervention. Interpretation of the results was guided by the Scaffolding Theory of Aging and Cognition.

Keywords:
Tower of Hanoi; executive cognitive function; older adults
Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012 ; 12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleSurprise Findings from Tower of Hanoi Research on Executive Cognitive Function in Older Adults: Assess, Intervene, or Both?en
dc.contributor.authorMildren, Whitney G.en
dc.contributor.authorCazzell, Mary A.en
dc.contributor.authorHolland, James Danielen
dc.contributor.departmentDelta Theta (Region 6)en
dc.author.detailsMildren, Whitney G., RN, BSN, wmildren@uta.edu; Cazzell, Mary A., RN, PhD; Holland, James D., MA;en
dc.identifier.urihttp://hdl.handle.net/10755/243490-
dc.description.abstract<b>Purpose: </b>The purpose was to determine feasibility, reliability, and item difficulty of the 22-task Tower of Hanoi (TOH), an executive cognitive function (ECF) puzzle game, in adults > 65 years. Neuroimaging research has documented prefrontal cortex (PFC) changes in aging: deficits in abstract thinking, problem solving, and loss of inhibitory control over irrelevant information. The 22-task TOH, a 4-disk transfer game across 3 vertical pegs, has never been administered to or scored on older adults nor has TOH psychometrics been established in this population. <p>'<b>Methods: </b>In this quantitative descriptive design, a convenience sample of 50 cognitively-intact independent-living older adults (> 65 years) completed 22 TOH tasks, 22 different start and end configurations. Eligibility included a pre-screening score of >26 score on the Montreal Cognitive Assessment. Rasch analysis was completed on: (1) item-difficulty estimation, (2) item characteristic curves, (3) item-and-person-fit statistics of predicted functioning, and (4) test information function on precision of TOH in differentiating ability levels. 22 tasks were scored for correct/incorrect, total moves, number of moves beyond minimal moves, and gender differences. Cronbach's alpha was obtained for reliability. <p>'<b>Results: </b>All participants completed 22 tasks. Older adults demonstrated a lower ability to solve even the easiest tasks. Most TOH items were more difficult than the demonstrated problem-solving skills needed to achieve expected number of moves. TOH reliability alpha was 0.69. Approximately 21% of all 22-items were performed correctly/participant. Females completed significantly more correct items than males (p<0.001). All incorrect moves were analyzed and number of extra moves beyond correct solution ranged from 2.8 to 11.4. <p>'<b>Conclusion: </b>Despite TOH's level of difficulty, participants reported increased self-confidence, improved perception of cognitive abilities, and greater motivation to further practice on TOH. This study introduces TOH as both a cognitive assessment tool and intervention. Interpretation of the results was guided by the Scaffolding Theory of Aging and Cognition.en
dc.subjectTower of Hanoien
dc.subjectexecutive cognitive functionen
dc.subjectolder adultsen
dc.date.available2012-09-12T09:22:59Z-
dc.date.issued2012-09-12-
dc.date.issued2012-09-12en
dc.date.accessioned2012-09-12T09:22:59Z-
dc.conference.date2012en
dc.conference.name23rd International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationBrisbane, Australiaen
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