Metacognition and the Mind

Thinking about thinking—and how we come to know what we know

Can Seeing a Doctor Give You Symptoms of Dementia?

Stereotype threat can make you perform poorly on tests of memory and dementia.

Taking a test, or being asked a question when on the spot, can make people anxious. As a result, being in certain situations can make people act in ways they might prefer to avoid, sometimes confirming certain negative stereotypes. Stereotype threat occurs when people fear, or become aware, that poor performance on their part will confirm a negative, self-relevant stereotype. In response to this threat, people tend to underperform compared to their actual potential, and thus will, in fact, confirm the stereotype that they were hoping to avoid. This can occur in classrooms with math anxiety, but also potentially in clinical settings, where the outcome could lead to a potential misdiagnosis.

One of the most common complaints and concerns of older adults are those related to memory failures. These complaints are especially concerning to those who are nearing old age (aka “younger” older adults). Seniors’ moments, forgetting someone’s name, or even the mention of grey hairs makes people think about declines in memory ability, or worse, the possibility of Alzheimer’s disease. Typically, older adults (around the age of 60) are stereotyped as having poorer memory abilities relative to college-aged younger adults. A great deal of research has shown that stereotype threat, and potential anxiety surrounding changes in memory ability, can in fact lead to poor memory ability!  So, when negative age-based stereotypes become salient to older adults (sometimes by simply asking an older adult, “how old are you?”), their memory performance decreases, thereby conforming to the stereotype.

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Several recent studies have shown some shocking effects of stereotype threat for older adults. Picture this: An older adults signs up for a university research study on memory and aging, and comes to the “Memory Lab” (a trigger for stereotype threat for older adults) to have their memory tested. They are tested by a younger college student (another trigger), and first must read the consent form, that further describes the study regarding memory and aging (trigger). Or worse, it also mentions the word “Alzheimer’s disease” as a possible measure of interest (a very worrying trigger). They are then asked how old they are (yes, another trigger, if you have to write you are indeed a senior), and then away they go, completing several memory tasks, all under loads of stereotype threat. In one study, they simply de-emphasized the “memory” aspect of the study by not using the word memory in the instructions, but rather “ability to learn”, and then older adults did much better on the same (now disguised) memory tasks!

Another recent study asked older adults how old they felt BEFORE starting the memory study (so, asking for their “subjective age,” which for older adults is often 5-10 years younger than their actual chronological age). However, when asked how old they felt AFTER completing the memory study, people reported feeling 5 years older even though the study only took five minutes! Interestingly, this didn’t occur if the older adult completed a task that did not have to do with memory. 

What is both striking and concerning is that stereotype threat can influence how older adults perform on tests for dementia. Taking a dementia screening test can be an anxiety-provoking experience. In a recent study conducted in the UK, 70 percent of older adults met diagnostic criteria for dementia when assessed under stereotype threat, compared to only 14 percent when not assessed under stereotype threat. Stereotype threat can be induced in a variety of ways, so it could be that simply seeing a younger doctor, who then asks about your memory, and asks your age, can lead you to forget things (and perform poorly on a test designed to assess the onset of dementia).

A recent study from the University of Toronto showed that older adults who believed that memory abilities were malleable (and could improve in old age, i.e., you can teach a dog new tricks) actually did better on several tests of memory, compared to those who felt that memory abilities are a fixed trait. So, if you think you can, then you probably can, illustrating the role of one's perspective on memory performance. Thus, there is a positive aspect to these research findings on beliefs about how memory changes with age, and it also illustrates the power of the mind, such that ways that reduce stereotype threat might also reduce forgetting (and also make you feel younger).  

Alan Castel, Ph.D., is an associate professor of cognitive psychology at the University of California, Los Angeles, and studies memory, metacognition and aging.

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