Attention and working memory in elderly: the influence of a distracting environment

Red flags for remote cognitive diagnostic assessment: A Delphi expert consensus study by the Canadian Consortium on Neurodegeneration in Aging

Despite the potential benefits of remote cognitive assessment for dementia, it is not appropriate for all clinical encounters. Our aim was to develop guidance on determining a patient's suitability for comprehensive remote cognitive diagnostic assessment for dementia. A multidisciplinary expert workgroup was convened under the auspices of the Canadian Consortium on Neurodegeneration in Aging. We applied the Delphi method to determine 'red flags' for remote cognitive assessment of dementia. This resulted in 14 red flags that met the predetermined consensus criteria. We then developed a novel clinical decision-making infographic that integrated these findings to support multidisciplinary clinicians in determining a patient's readiness to undergo comprehensive remote cognitive assessment.

Age-Related Decline in Disengaging Spatial Attention in Physiological Aging

Background/Objectives: Attention is a complex process involving various components such as alerting, orienting, and resolving conflicts. These components have been widely examined using the Attention Network Test (ANT), which has also been used to explore attentional decline associated with aging. However, discrepancies exist in the literature regarding which specific aspects of attention are most impacted by aging. These inconsistencies could be due to methodological issues such as group comparisons that may exaggerate differences between groups while flattening subtle variations within groups. Methods: To address this issue, we administered the ANT to 60 healthy participants aged between 62 and 90 years. Using a multivariate regression analysis, we examined whether increasing age was associated with changes in alerting, orienting, and conflict resolution, while controlling for overall performance in terms of both reaction times and accuracy. Results: The results showed a general and age-insensitive decline in two of the three attentional components: the alerting effect, which was abolished, and a large conflict effect, which was present regardless of age. In contrast, the orienting of spatial attention was found to linearly increase with increasing age. More focused analyses revealed that the ability to shift attention from the central (initial) to the peripheral (target) location slowed down as a function of age. Conclusions: These results suggest that aging is associated with a greater difficulty in disengaging endogenous attention from the central, uninformative cue to direct attention on task-relevant peripheral targets.

Effect of Repeated Exposure to the Visual Environment on Young Children's Attention

Prior research suggests that visual features of the classroom environment (e.g., charts and posters) are potential sources of distraction hindering children's ability to maintain attention to instructional activities and reducing learning gains in a laboratory classroom. However, prior research only examined short-term exposure to elements of classroom décor, and it remains unknown whether children habituate to the visual environment with repeated exposure. In study 1, we explored experimentally the possibility that children may habituate to the visual environment if the visual displays are static. We measured kindergarten children's patterns of attention allocation in a decorated classroom environment over a 2-week period and compared the percentage of time children spent off-task to a baseline condition in which the classroom environment was streamlined (i.e., charts, posters, and manipulatives were removed). The findings indicate that with more prolonged exposure to a static visual environment, partial habitation effects were observed: Attention to the environment declined at the end of the exposure period compared to the beginning of the study; however, the environment remained a significant source of off-task behavior even after 2 weeks of exposure. In study 2, we extend this work by conducting a longitudinal observation of six primary classrooms in which we measured children's patterns of attention allocation in real classrooms for 15 weeks to investigate whether increasing familiarity with the classroom décor would influence attention toward the visual environment. No evidence of habituation was observed in genuine classrooms in study 2. Potential implications for classroom design and future directions are discussed.

How the motor system copes with aging: a quantitative meta-analysis of the effect of aging on motor function control

Motor cognitive functions and their neurophysiology evolve and degrade along the lifespan in a dramatic fashion. Current models of how the brain adapts to aging remain inspired primarily by studies on memory or language processes. Yet, aging is strongly associated with reduced motor independence and the associated degraded interaction with the environment: accordingly, any neurocognitive model of aging not considering the motor system is, ipso facto, incomplete. Here we present a meta-analysis of forty functional brain-imaging studies to address aging effects on motor control. Our results indicate that motor control is associated with aging-related changes in brain activity, involving not only motoric brain regions but also posterior areas such as the occipito-temporal cortex. Notably, some of these differences depend on the specific nature of the motor task and the level of performance achieved by the participants. These findings support neurocognitive models of aging that make fewer anatomical assumptions while also considering tasks-dependent and performance-dependent manifestations. Besides the theoretical implications, the present data also provide additional information for the motor rehabilitation domain, indicating that motor control is a more complex phenomenon than previously understood, to which separate cognitive operations can contribute and decrease in different ways with aging.

Many aspects of neuronal control degrade with ageing, including motor control. Using a meta-analysis of functional MRI images, it is made apparent that the ageing brain relies more on visual strategies than sensory stimuli to maintain motor function.

The Performance Index Identifies Changes Across the Dual Task Timed Up and Go Test Phases and Impacts Task-Cost Estimation in the Oldest-Old

Introduction: Dual tasking is common in activities of daily living (ADLs) and the ability to perform them usually declines with age. While cognitive aspects influence dual task (DT) performance, most DT-cost (DT-C) related metrics include only time- or speed- delta without weighting the accuracy of cognitive replies involved in the task.

Objectives: The primary study goal was to weight the accuracy of cognitive replies as a contributing factor when estimating DT-C using a new index of DT-C that considers the accuracy of cognitive replies (P-index) in the instrumented timed up and go test (iTUG). Secondarily, to correlate the novel P-index with domains of the Mini-Mental State Examination (MMSE).

Methods: Sixty-three participants (≥85 years old) took part in this study. The single task (ST) and DT iTUG tests were performed in a semi-random order. Both the time taken to complete the task measured utilizing an inertial measurement unit (IMU), and the accuracy of the cognitive replies were used to create the novel P-index. Clinical and sociodemographic data were collected.

Results: The accuracy of the cognitive replies changed across the iTUG phases, particularly between the walk 1 and walk 2 phases. Moreover, weighting 0.6 for delta-time (W₁) and 0.4 for cognitive replies (W₂) into the P-index enhanced the prediction of the MMSE score. The novel P-index was able to explain 37% of the scores obtained by the fallers in the “spatial orientation” and “attention” domains of the MMSE. The ability of the P-index to predict MMSE scores was not significantly influenced by age, schooling, and number of medicines in use. The Bland-Altman analysis indicated a substantial difference between the time-delta-based DT-C and P-index methods, which was within the limits of agreement.

Conclusions: The P-index incorporates the accuracy of cognitive replies when calculating the DT-C and better reflects the variance of the MMSE in comparison with the traditional time- or speed-delta approaches, thus providing an improved method to estimate the DT-C.

Semantic Congruence Drives Long-Term Memory and Similarly Affects Neural Retrieval Dynamics in Young and Older Adults

Learning novel information can be promoted if it is congruent with already stored knowledge. This so-called semantic congruence effect has been broadly studied in healthy young adults with a focus on neural encoding mechanisms. However, the impacts on retrieval, and possible impairments during healthy aging, which is typically associated with changes in declarative long-term memory, remain unclear. To investigate these issues, we used a previously established paradigm in healthy young and older humans with a focus on the neural activity at a final retrieval stage as measured with electroencephalography (EEG). In both age groups, semantic congruence at encoding enhanced subsequent long-term recognition memory of words. Compatible with this observation, semantic congruence led to differences in event-related potentials (ERPs) at retrieval, and this effect was not modulated by age. Specifically, congruence modulated old/new ERPs at a fronto-central (Fz) and left parietal (P3) electrode in a late (400–600 ms) time window, which has previously been associated with recognition memory processes. Importantly, ERPs to old items also correlated with the positive effect of semantic congruence on long-term memory independent of age. Together, our findings suggest that semantic congruence drives subsequent recognition memory across the lifespan through changes in neural retrieval processes.

The impact of computer-based cognitive training intervention on the quality of life among elderly people: a randomized clinical trial

Background

Through the process of normal aging, cognitive decline would cause a lower level of functioning in real life. This flow might interfere with health-related quality of life (QoL). The purpose of this study is to investigate the effect of computer-based cognitive intervention on increasing QoL of elderly people.

Methods

A total number of 52 community-dwelling older adults participated in this study. This community scored ≥ 21 in the Mini-Mental State Examination (MMSE) and a clock drawing test score ≥ 4 from health centers in Tehran, Iran. This study is a parallel group stratified randomized clinical trial. The intervention group received a 45-min cognitive training session twice a week for 10 sessions, using Attentive Rehabilitation of Attention and Memory (ARAM) software focusing on selective attention and working memory. QoL was evaluated as a primary outcome. The control group participated in educational workshops.

Results

From fifty-two persons, only one participant was excluded from the study in the intervention group during follow-up. Results revealed by increasing cognitive function, improvement occurred in QoL (F = 13.417, p value < 0.001, partial eta-squared = 0.324) as a primary outcome in the intervention group. Among eight domains of QoL, there was significant increasing in domain of role limitations due to emotional problems (F = 4.007, p value = 0.021, partial eta-squared = 0.059), social functioning (F = 2.423, p value = 0.044, partial eta-squared = 0.004), and role limitations due to physical health (F = 10.749, p value < 0.001, partial eta-squared = 0.026).

Conclusions

Based on the results, ARAM showed transition and long-term effects on QoL in elderly people by improving cognitive functions such as selective attention and working memory.

Trial registration

Iranian Registry of Clinical Trials IRCT2016122731602N1. Registered on June 21, 2017

The perceived challenge of everyday technologies in Sweden, the United States and England: Exploring differential item functioning in the everyday technology use questionnaire

Background: The changing technological environment is reflected in regular updates made to the everyday technology (ET) use questionnaire (ETUQ). Newly added ETs may not present comparable challenges across countries and diagnoses.Aims: To identify whether country context, or dementia diagnosis, impact ETs' challenge level.Material and methods: 315 older adults from three countries were included; Sweden (n = 73), United States (n = 114), England (n = 128), and had a confirmed diagnosis of mild dementia (n = 99) or no known cognitive impairment (n = 216). Differential Items Functioning (DIF) analysis was performed on 88 ETs included in the ETUQ by country and diagnosis. The impact of DIF was evaluated in a Differential Test Functioning (DTF) analysis.Results: Nine items (10.2%) in the ETUQ showed statistically significant DIF between countries; five of which were public space ETs and none of which were information and communication technologies (ICTs). Three ICT items, and no others, showed significant DIF by diagnosis. The items' DIF was shown to have no impact upon person measures of ability to use ET in the DTF.Conclusions and significance: The utility of the ETUQ in occupational therapy practice and research internationally is highlighted through the stability of the challenge hierarchy and lack of impact on person measures.

When visual stimulation of the surrounding environment affects children's cognitive performance

Visual distraction is widely studied in children, particularly in visuospatial cognitive tasks. In these studies, targets and distractors are usually shown in the same display (e.g., the computer screen). However, children are constantly exposed to visually enriched environments (e.g., elementary school classrooms), and little is known about their influence on children's cognition. Although the importance of the surrounding environment is well recognized in the literature, few experimental studies have explored this question. We propose an alternative paradigm to study visual distraction in children that brings together the rigor of experimental psychology and more ecological validity on the exposure to potential environmental distractors. Our study was designed to investigate whether a high-load versus low-load visual surrounding environment influences children's cognitive performance as evaluated by four different cognitive tasks. A sample of 64 children (aged 8-12 years) completed two sessions in two environmental conditions: a high-load visual surrounding environment and a low-load environment. In each session, they performed visuospatial attention and memory tasks. Overall, the results suggested that the high-load visual environment affected children's cognitive performance given that children performed better in the low-load visual environment (e.g., higher percentage of hits, higher Corsi span). Understanding the impact that a visually rich surrounding environment has on children's cognitive processes that support more complex ones is important to support recommendations on how the environment should be organized to foster better daily activities.

Disruptive Effects of Colorful vs. Non-colorful Play Area on Structured Play-A Pilot Study with Preschoolers

To contribute to young children's development, sensory enrichment is often provided via colorful play areas. However, little is known about the effects of colorful environments on children while they engage in age-appropriate tasks and games. Studies in adults suggest that aspects of color can distract attention and impair performance, and children are known to have less developed attentional and executive abilities than adults. Preliminary studies conducted in children aged 5-8 suggest that the colorfulness of both distal (e.g., wall decorations) and proximal (e.g., the surface of the desktop) environments can have a disruptive effect on children's performance. The present research seeks to extend the previous studies to an even younger age group and focus on proximal colorfulness. With a sample of 15 pre-schoolers (3-4 years old) we examined whether a colorful play surface compared to a non-colorful (white) play surface would affect engagement in developmentally appropriate structured play. Our pilot findings suggest that a colorful play surface interfered with preschoolers' structured play, inducing more behaviors indicating disruption in task execution compared with a non-colorful play surface. The implications of the current study for practice and further research are discussed.

Processos Cognitivos Visuoespaciais e Ambiente Visual Circundante: Implicações Educacionais

RESUMO Nesta revisão de literatura, abordamos a importância da atenção seletiva, da inibição e da memória de trabalho na aprendizagem das crianças. Começamos por apresentar as suas definições e principais mecanismos funcionais. Apresentamos igualmente conclusões de vários estudos que abordam a importância desses processos, sobretudo em tarefas visuoespaciais. Finalmente, abordamos o papel que o ambiente visual circundante desempenha na aprendizagem, chamando a atenção para uma lacuna que se verifica em grande parte dos estudos: a sua pouca validade ecológica. É também defendido que o ambiente visual externo deve ser considerado nos modelos explicativos dos processos cognitivos básicos. Conclui-se o trabalho alertando para a necessidade de se estudar de forma mais sistemática a relação entre estes dois elementos (cognição e ambiente).