We examined whether older and younger adults share a schema for taking medication and whether instructions are better recalled when they are organized to match this schema. Experiment 1 examined age differences in schema organization. Participants sorted medication items (e.g., purpose, dose, possible side effects) according to similarity and then ordered the items to create a preferred instruction set. Cluster analysis of the sort and order data showed that younger and older adults share a schema for taking medication. Secondary regression analyses found that verbal ability (i.e., vocabulary scores) predicted individual differences in schema organization. In Experiment 2 participants recalled instructions that were either compatible with this schema in terms of grouping and order of items or were presented in nonpreferred orders. Younger participants remembered more information than did older participants, but both age groups better remembered and preferred the more schema-compatible instructions. Secondary analyses showed that recall was also positively related to verbal ability. Along with our earlier research, this study suggests that older and younger adults possess a schema for taking medication and that instructions that are compatible with this schema provide an environmental support that improves memory for medication information.
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References
1.
Alba, J. W., & Hasher, L. (1983). Is memory schematic?Psychological Bulletin, 93, 203–231.
2.
Aldendorfer, M., & Blashfield, R. (1984). Cluster analysis.. Newbury Park, CA: Sage.
3.
Borgatta, E., & Corsini, R. (1964). Quick word test manual: Directions for administering, scoring, and interpreting.. New York: Harcourt Brace Jovanovich.
4.
Boyd, J., Covington, T., Stanaszek, W., & Coussons, R. (1974). Drug defaulting: Part 2. Analysis of noncompliance patterns. American Journal of Hospital Pharmacy,31, 485–491.
5.
Craik, F. I. M. (1986). A functional account of age difference in memory. In F. Klix & H. Hagendorf, (Eds.), Human memory and cognitive capabilities (pp. 409–422. Amsterdam: Elsevier.
6.
Dixon, P., Faries, J., & Gabrys, G. (1988). The role of explicit action statements in understanding and using written directions. Journal of Memory and Language,27, 649–667.
7.
Ellis, H. C., & Franklin, J. B. (1983). Memory and personality: External versus internal locus of control and superficial organization in free recall. Journal of Verbal Learning and Verbal Behavior,22, 61–74.
8.
Gardner, M., Rulien, N., McGhan, W., & Mead, R. (1988). A study of patients' perceived importance of medication information provided by physicians in a health maintenance organization. Drug Intelligence and Clinical Pharmacy,22, 596–598.
9.
Hartley, J. (1993). Aging and prose memory: Tests of the resource-deficit hypothesis. Psychology and Aging,8, 538–551.
10.
Hess, T. (1990). Aging and semantic influences on memory. In T. M. Hess (Ed.), Aging and cognition: Knowledge organization and utilization (pp. 93–160. Amsterdam: North-Holland.
11.
Holland, J., & Merikle, P. (1987). Menu organization and user expertise in information search tasks. Human Factors,29, 577–586.
12.
Hultsch, D., & Dixon, R. (1983). The role of pre-experimental knowledge in text processing in adulthood. Experimental Aging Research,9, 17–22.
13.
Hutchins, E. L., Hollan, J. D., & Norman, D. A. (1985). Direct manipulation interfaces. Human-Computer Interaction,1, 311–338.
14.
Janz, N., & Becker, M. (1984). The health belief model: A decade later. Health Education Quarterly,11, 1–47.
15.
Krantz, D. S., Baum, A., & Wideman, M. V. (1980). Assessment of preferences for self-treatment and information in health care. Journal of Personality and Social Psychology,39, 977–990.
16.
Lachman, M. E. (1983). Perceptions of intellectual aging: Antecedent or consequence of intellectual functioning?Developmental Psychology,19, 482–498.
17.
Lachman, M. E. (1986). Locus of control in aging research: A case for multidimensional and domain-specific assessment. Journal of Psychology and Aging,1, 34–40.
18.
Leirer, V., Morrow, D., Tanke, E., & Pariante, G. (1991). Elders' nonadherence: Its assessment and medication reminding by voice mail. Gerontologist,31, 514–520.
19.
Ley, P. (1978). Memory for medication information. In M. Gruneberg, P. Morris, & R. Sykes, (Eds.), Practical aspects of memory (pp. 120–127. London: Academic.
20.
Loewen, E. R., Shaw, R. J., & Craik, F. I. M. (1990). Age differences in components of metamemory. Experimental Aging Research,16, 43–48.
21.
Meyer, B. (1987). Reading comprehension and aging. In W. Schaie (Ed.), Annual review of gerontology and geriatrics (pp. 93–115. New York: Springer.
22.
Morrell, R., Park, D., & Poon, L. (1989). Quality of instructions on prescription drug labels: Effects on memory and comprehension in young and old adults. Gerontologist,29, 345–354.
23.
Morrow, D. G. (1996). Improving consultations between health professionals and clients: Implications for pharmacists. International Journal of Aging and Human Development,44, 47–72.
24.
Morrow, D. G., Leirer, V., & Altieri, P. (1995). List formats improve medication instructions for older adults. Educational Gerontology,21, 163–178.
25.
Morrow, D., Leirer, V., Altieri, P., & Andrassy, J. (1994). Organization of medication labels. Manuscript in preparation.
26.
Morrow, D., Leirer, V., Altieri, P., & Fitzsimmons, C. (1994). When expertise reduces age differences in performance. Psychology and Aging,9, 134–148.
27.
Morrow, D., Leirer, V., Altieri, P., & Tanke, E. (1991). Elders' schema for taking medication: Implications for instruction design. Journal of Gerontology: Psychological Sciences,48, 378–385.
28.
Morrow, D., Leirer, V., Andrassy, J., & Tanke, E. D. (1995). Designing health service reminder messages for older adults. Journal of Clinical Geropsychology,1, 293–304.
29.
Morrow, D., Leirer, V., & Sheikh, J. (1988). Adherence and medication instructions: Review and recommendations. Journal of the American Geriatric Society,36, 1147–1160.
30.
Park, D. C. (1992). Applied cognitive aging research. In F. I. M. Craik & T. A. Salthouse, (Eds.), The handbook of aging and cognition (pp. 449–493). Hillsdale, NJ: Erlbaum.
31.
Rice, G., & Okun, M. (1994). Older readers' processing of medical information that contradicts their beliefs.Journal of Gerontology: Psychological Sciences,48, P119–128.
32.
Robinson-Whelen, S., & Storandt, M. (1992). Factorial structure of two health belief measures among older adults. Psychology and Aging,7, 209–213.
33.
Salthouse, T. A. (1990). Influence of experience on age differences in cognitive functioning. Human Factors,32, 551–569.
34.
SAS Institute, Inc. (1985). SAS user's guide: Statistics (Version 5). Cary, NC: Author.
35.
Sharpe, T., & Mikeal, R. (1974). Patient compliance with antibiotic regimes. American Journal of Hospital Pharmacy,31, 479–484.
36.
Smith, S., Rebok, G., Smith, W., Hall, S. E., & Alvin, M. (1983). Adult age differences in the use of story structure in delayed free recall. Experimental Aging Research,9, 191–195.
37.
Stine, E., Lachman, M., & Wingfield, A. (1993). The roles of perceived and actual control in memory for spoken language. Educational Gerontology,19, 331–349.
38.
Stine, E., & Wingfield, A. (1990). The assessment of qualitative age difference in discourse processing. In T. Hess, (Ed.), Aging and cognition: Knowledge organization and utilization (pp. 33–92. Amsterdam: North-Holland.
39.
Stine, E., Wingfield, A., & Poon, L. (1986). How much and how fast: Rapid processing of spoken language in later adulthood. Psychology and Aging,1, 303–311.
40.
Vicente, K. J. (1992). Memory recall in a process recall system: A measure of expertise and display effectiveness. Memory and Cognition,20, 356–373.
41.
Wallston, K. A., Wallston, B. S., & DeVellis, R. (1978). Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Education Monographs,6, 160–170.
42.
Wilson, J., & Rutherford, A. (1989). Mental models: Theory and application in human factors. Human Factors,31, 617–634.
43.
Woodward, N., & Wallston, B. (1987). Age and health care beliefs: Self-efficacy as a mediator of low desire for control. Psychology and Aging,2, 3–8.
44.
Zacks, R., Hasher, L., Doren, B., Hamm, V., & Attig, M. (1987). Encoding and memory of explicit and implicit information. Journal of Gerontology,42, 418–422.
