How Stereotype Threat Affects Healthy Older Adults' Performance on Clinical Assessments of Cognitive Decline: The Key Role of Regulatory Fit

Abstract

Objectives: Stereotype threat can impair older adults' performance on clinical assessments for cognitive decline. We examined why this occurs. Based upon the regulatory focus account of stereotype threat, we predicted that the effects of stereotype threat should depend upon the assessments' reward structure. Stereotype threat should be associated with poor performance when the assessment emphasizes gaining correct answers, but not when it emphasizes avoiding mistakes.

Method: Healthy older adults completed a series of mental status examinations. Half of the participants completed these examinations under stereotype threat about their cognitive abilities. Monetary incentives were also manipulated. For half of the participants correct responding led to gains. For the remaining participants incorrect responding/forgetting led to losses.

Results: Consistent with the regulatory focus account, stereotype threat was associated with poor performance when the mental status examinations had a gains-based structure, but not when they had a losses-based structure.

Discussion: Older adults respond to stereotype threat by becoming vigilant to avoid the losses that will make them their worst. Researchers and clinicians can capitalize on this motivational change to combat stereotype threat's negative effects. By using a loss-avoidance frame, stereotype threat's negative effects can be attenuated or even eliminated.

Keywords: Aging; Memory; Regulatory fit; Regulatory focus; Stereotype threat.

Figure 1.

Adjusted performance on the critical mini mental state examination (MMSE; embedded in the Addenbrooke’s Cognitive Examination-Revised [ACE-R]) as a function of stereotype threat and task reward structure. Means are adjusted for the covariates of educational attainment, chronological age, sex, and baseline MMSE performance. Error bars represent the adjusted standard errors of the means.

Figure 2.

Adjusted performance on the critical Word List Memory Test from the Consortium to Establish a Registry on Alzheimer’s disease (CERAD) as a function of stereotype threat and task reward structure. Means are adjusted for the covariates of educational attainment, chronological age, sex, and baseline Control Word List Memory Test performance. Error bars represent the adjusted standard errors of the means.

Figure 3.

Conceptual diagram of the moderated-mediation analysis.