Sustained attention in the elderly: what do we know and what does it tell us about cognitive aging?

The Role of Sleep for Age-Related Differences in Neurobehavioral Performance

This study investigated developmental changes from childhood to adulthood in neurobehavioral performance and sleep measures. While many studies have examined age-related changes between childhood and adolescence and from mid-to-late adulthood, young adulthood has been overlooked. The main aim of this study was to investigate the effects of sleep loss on developmental changes in neurobehavioral performance and sleepiness in a natural setting. A total of 119 children, adolescents, and young adults (38 children aged 6-9; 38 adolescents aged 13-19; and 43 young adults aged 20-27) wore an actigraph for a continuous five-weekday night. Subjective sleepiness (Karolinska Sleepiness Scale) and neurobehavioral performance (using the psychomotor vigilance test and the digit symbol substitution test) were measured on five school days. The results showed that adolescents and young adults outperformed children on both the digit symbol substitution test and the psychomotor vigilance test measures. However, adolescents committed more errors of commission on the psychomotor vigilance test and reported higher levels of subjective sleepiness. The results are discussed in relation to brain maturation in various cognitive functions.

Cognitive Changes Associated with Aging and Physical Disease in Dogs and Cats

Behavior changes may indicate primary physical disease or primary behavioral disorders in veterinary patients. It is imperative to recognize that secondary behavioral problems can develop due to medical causes. The incidence of systemic disease increases with age and behavior manifestations can be similar to those expected with cognitive dysfunction syndrome. In this article, we review basic concepts of cognition, aging, and cognitive dysfunction syndrome. Additionally, we provide information regarding factors that influence cognition, and the role medical conditions have on the behavior of aging pets.

Risk Polymorphisms of FNDC5, BDNF, and NTRK2 and Poor Education Interact and Aggravate Age-Related Cognitive Decline

Cognitive abilities tend to decline with aging, with variation between individuals, and many studies seek to identify genetic biomarkers that more accurately anticipate risks related to pathological aging. We investigated the influence of BDNF, NTRK2, and FNDC5 single nucleotide polymorphisms (SNPs) on the cognitive performance of young and older adults with contrasting educational backgrounds. We addressed three questions: (1) Is education associated with reduced age-related cognitive decline? (2) Does the presence of SNPs explain the variation in cognitive performance observed late in life? (3) Is education differentially associated with cognition based on the presence of BDNF, NTRK2, or FNDC5 polymorphisms? We measured the cognitive functions of young and older participants, with lower and higher education, using specific and sensitive tests of the Cambridge Automated Neuropsychological Test Assessment Battery. A three-way ANOVA revealed that SNPs were associated with differential performances in executive functions, episodic memory, sustained attention, mental and motor response speed, and visual recognition memory and that higher educational levels improved the affected cognitive functions. The results revealed that distinct SNPs affect cognition late in life differentially, suggesting their utility as potential biomarkers and emphasizing the importance of cognitive stimulation that advanced education early in life provides.

Quantifying attention span across the lifespan

Introduction

Studies examining sustained attention abilities typically utilize metrics that quantify performance on vigilance tasks, such as response time and response time variability. However, approaches that assess the duration that an individual can maintain their attention over time are lacking.

Methods

Here we developed an objective attention span metric that quantified the maximum amount of time that a participant continuously maintained an optimal "in the zone" sustained attention state while performing a continuous performance task.

Results

In a population of 262 individuals aged 7-85, we showed that attention span was longer in young adults than in children and older adults. Furthermore, declines in attention span over time during task engagement were related to clinical symptoms of inattention in children.

Discussion

These results suggest that quantifying attention span is a unique and meaningful method of assessing sustained attention across the lifespan and in populations with inattention symptoms.

Aging effects and feasibility of statistical learning tasks across modalities

Knowledge on statistical learning (SL) in healthy elderly is scarce. Theoretically, it is not clear whether aging affects modality-specific and/or domain-general learning mechanisms. Practically, there is a lack of research on simplified SL tasks, which would ease the burden of testing in clinical populations. Against this background, we conducted two experiments across three modalities (auditory, visual and visuomotor) in a total of 93 younger and older adults. In Experiment 1, SL was induced in all modalities. Aging effects appeared in the tasks relying on an explicit posttest to assess SL. We hypothesize that declines in domain-general processes that predominantly modulate explicit learning mechanisms underlie these aging effects. In Experiment 2, more feasible tasks were developed for which the level of SL was maintained in all modalities, except the auditory modality. These tasks are more likely to successfully measure SL in elderly (patient) populations in which task demands can be problematic.

The Role of Sleep Patterns from Childhood to Adolescence in Vigilant Attention

Only a few studies addressed age-related changes from childhood to adolescence in sleep patterns, sleepiness, and attention. Vigilant attention plays a key role in cognitive performance. While its nature and course have been investigated broadly among adults, only limited research has been conducted on its development between childhood and adolescence. The main aim of the current study was to replicate previous findings about the effects of sleep loss on age-related changes in vigilance attention performance and sleepiness in a natural setting. A total of 104 children and adolescents (46 children aged 6-9 and 58 adolescents aged 13-19) wore an actigraph for a continuous five to seven nights, including weekdays and weekends. Subjective sleepiness (Karolinska Sleepiness Scale) and a Psychomotor Vigilance Test (PVT-B) were measured on two school days and one non-school day. Findings showed that PVT-B performance differed by age group, with adolescents outperforming children in PVT-B measures in spite of their elevated subjective sleepiness. Adolescents demonstrated less sleep time and increased sleepiness. Although PVT-B performance was better among adolescents, a within-subject analysis revealed that adolescents performed better on PVT measures on weekends than on weekdays. The results are discussed in relation to the synaptic elimination model.

The reliability, functional quality, understandability, and actionability of fall prevention content in YouTube: an observational study

Background

Falls are common but dangerous in the elderly. More and more seniors are searching for healthcare information online. YouTube has become the world’s most popular video streaming platform. Albeit thousands of fall prevention videos are available on YouTube, their reliability, functional quality, understandability, and actionability have not been verified.

Methods

The top 300 watched videos on YouTube related to fall prevention were retrieved. After exclusion, all qualified sample videos were evaluated by three validated assessment instruments (the PEMAT scale, the HONCode scale, and the DISCERN instrument) regarding their reliability, functional quality, understandability, and actionability. Each video’s length, number of views/likes/comments, forms of expression, and the uploader’s profile were collected as well. The Wilcoxon rank sum test was performed for further analysis from the perspective of expression forms and uploaders’ identities.

Results

One hundred thirty-seven videos (45.67%) were qualified as sample videos, and individuals/organizations with medical backgrounds posted 54.01% of them. Most of the excluded videos (n = 163) were irrelevant (n = 91, 55.83%), and commercial (n = 52, 31.90%). The median video length for sample videos was 470 seconds. The DISCERN instrument indicated that 115 videos (83.94%) were of moderate to high overall quality. Medical practitioners and organizations gained the highest scores in functional quality and reliability (P < 0.05), while they also tended to use technical terms more often (mean = 3.15). The HONCode scale suggested a lack of traceability was common. The most popular and actionable form of expression was workout (n = 58, median score = 86.90, P < 0.05), while monolog and keynote presentations scored the highest in understandability (no significant difference between them). The PEMAT scale suggested videos uploaded by medical teams were the easiest to be understood (P = 0.011 and P < 0.001, respectively), whereas they were less actionable than those made by fitness trainers (P = 0.039 and P < 0.001, respectively).

Conclusions

Cooperation between the medical team and fitness trainers is expected for better health promotion. Plain language is advised, and sources should be provided. As for expression form, monolog or keynote presentations, plus workout clips, might be the most effective.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03330-x.

How Does Ageing Affect Social Attention? A Test of Competing Theories using Multi-Level Meta-Analysis

Objectives

The present study provides a meta-analytic assessment of how gaze-cued attention—a core social-cognitive process—is influenced by normal adult aging.

Methods

A multilevel meta-analysis of standardized mean changes was conducted on gaze-cueing effects. Age effects were quantified as standardized mean differences in gaze-cueing effect sizes between young and older adult samples.

Results

We identified 82 gaze-cueing effects (k = 26, N = 919 participants). Of these, 37 were associated with young adults (k = 12, n = 438) and 45 with older adults (k = 14, n = 481). Relative to younger adults, older adults had a reduced gaze-cueing effect overall, g = −0.59, with this age effect greater when the cues were predictive, g = −3.24, rather than nonpredictive, g = −0.78.

Discussion

These results provide the clearest evidence to date that adult aging is associated with a reduction in gaze-cued attention. The results also speak to potential mechanisms of this age effect. In line with cognitive decline models of aging, it was demonstrated that when gaze cues were predictive, only younger adults seem to benefit, suggesting that older adults exhibit a particularly reduced capacity to use gaze cues volitionally.

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.

Evidence that ageing yields improvements as well as declines across attention and executive functions

Many but not all cognitive abilities decline during ageing. Some even improve due to lifelong experience. The critical capacities of attention and executive functions have been widely posited to decline. However, these capacities are composed of multiple components, so multifaceted ageing outcomes might be expected. Indeed, prior findings suggest that whereas certain attention/executive functions clearly decline, others do not, with hints that some might even improve. We tested ageing effects on the alerting, orienting and executive (inhibitory) networks posited by Posner and Petersen's influential theory of attention, in a cross-sectional study of a large sample (N = 702) of participants aged 58-98. Linear and nonlinear analyses revealed that whereas the efficiency of the alerting network decreased with age, orienting and executive inhibitory efficiency increased, at least until the mid-to-late 70s. Sensitivity analyses indicated that the patterns were robust. The results suggest variability in age-related changes across attention/executive functions, with some declining while others improve.

Short-term memory, attention, and temporal orientation as predictors of the cognitive impairment in older adults: A cross-sectional observational study

Late-life cognitive decline ranges from the mildest cases of normal, age-related change to mild cognitive impairment to severe cases of dementia. Dementia is the largest global burden for the 21st century welfare and healthcare systems. The aim of this study was to analyze the neuropsychological constructs (temporal orientation (TO), spatial orientation (SO), fixation memory (FM), attention (A), calculation (C), short-term memory (STM), language (L), and praxis (P)), semantic fluency, level of functionality, and mood that reveal the greatest deficit in the different stages ranging from normal cognition (NC) to cognitive impairment in older adults in a primary healthcare setting. The study included 337 participants (102 men, 235 women), having a mean age of 74 ± 6 years. According to their scores on the Spanish version of the Mini-Mental State Examination (MEC-35), subjects were divided into 4 groups: no deterioration (ND) (score 32-35), subtle cognitive impairment (SCI) (score 28-31), level deterioration (LD) (score 24-27) and moderate deterioration (MD) (score 20-23). The ND group revealed significant differences in TO, STM, C, A, L, P, and S-T as compared to the other groups. The MD group (in all the neuropsychological constructs) and the ND and SCI groups showed significant differences on the Yesavage geriatric depression scale (GDS-15). All except the FM neuropsychological construct were part of the MEC-35 prediction model and all of the regression coefficients were significant for these variables in the model. Furthermore, the highest average percentage of relative deterioration occurs between LD and MD and the greatest deterioration is observed in the STM for all groups, including A and TO for the LD and MD groups. Based on our findings, community programs have been implemented that use cognitive stimulation to prevent cognitive decline and to maintain the neuropsychological constructs.

Spousal bereavement and the cognitive health of older adults in the US: New insights on channels, single items, and subjective evidence

This study provides novel insights into older adults' cognitive functioning before and after widowhood onset and possible effect channels. It further examines gender heterogeneity in the adaptation to (anticipated or actual) spousal bereavement, comparing objective evidence with subjective evidence of cognitive abilities. We used longitudinal data of up to 26,584 participants of the Health and Retirement Study, aged over 50 at recruitment, assessed biennially between 1998 and 2016. Two-way fixed effects with dynamic treatment effects were estimated for various cognitive measures, including six aggregated indices and six single item scales. After adjusting for effect channels including depression, social vulnerability, and stress, there remained significant widowhood effects on older adults' cognitive health. Using single item scales, we established the adverse contemporaneous and adaptation effects on bereaved older females' short-term memory, semantic memory, and numeracy. For bereaved older males, working memory and focus-of-attention deteriorated after widowhood onset. Meanwhile, subjective memory rating remained intact, contrary to objective evidence. We conclude that cognitive transitions to and from widowhood can exhibit distinctive patterns across objective and subjective cognitive domains. With the effect channels in mind, cognitive intervention for widowed older adults should be tailored to the temporal distance to spousal loss, gender, and task.

A Comparison of the Performance between the 60- and 120-Second Conditions of the Korean-Color Word Stroop Test: Color Reading (K-CWST: CR)

Background and Purpose

The Korean-Color Word Stroop Test: Color Reading (K-CWST: CR) included in the Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II) examines inhibitory control deficit. It provides normative data for both 60- and 120-second conditions, but the validity of the 60-second condition has not yet been proven. This study examined the validity of the 60-second condition by observing concordance between the performances in cognitively normal, MCI, and mild dementia groups.

Methods

There were 1,336 patients performed the SNSB-II, including the K-CWST: CR. Based on the cognitive test results, activities of daily living, and clinical interview, the patients were assigned to normal cognition (n=104), MCI (n=884), or mild dementia (n=348) groups. Abnormal performance on the K-CWST: CR was operationally defined as 1SD below the normative mean. The receiver operating characteristic curve analyses were conducted to compare the discriminability between the 60- and 120-second conditions.

Results

The percentages of abnormal performance in the MCI group were 41.5% and 42.3%, and those in the mild dementia group were 82.7% and 82.4% for the 60- and 120-second conditions, respectively. The areas under the curve for the 60- and 120-seconds were as follows; 0.80 and 0.81 in differentiating normal from MCI; 0.95 and 0.96 in normal from mild dementia; and 0.77 and 0.77 in MCI from mild dementia.

Conclusions

The 60-second condition of the K-CWST showed very similar results, not statistically different from the 120-second condition. Therefore, the 60-second condition could be used interchangeably with the 120-second condition in a clinical setting.

Age differences in sustained attention tasks: A meta-analysis

Many aspects of attention decline with aging. There is a current debate on how aging also affects sustained attention. In this study, we contribute to this debate by meta-analytically comparing performance on the go/no-go Sustained Attention to Response Task (SART) in younger and older adults. We included only studies in which the SART had a low proportion of no-go trials (5%–30%), there was a random or quasirandom stimulus presentation, and data on both healthy younger and older adults were available. A total of 12 studies were suitable with 832 younger adults and 690 older adults. Results showed that older adults were slower than younger adults on go trials (g = 1, 95% CI [.72, 1.27]) and more accurate than younger adults on no-go trials (g = .59, 95% CI [.32, .85]). Moreover, older adults were slower after a no-go error than younger adults (g = .79, 95% CI [.60, .99]). These results are compatible with an age-related processing speed deficit, mostly suggested by longer go RTs, but also with an increased preference for a prudent strategy, as demonstrated by fewer no-go errors and greater posterror slowing in older adults. An inhibitory deficit account could not explain these findings, as older adults actually outperformed younger adults by producing fewer false alarms to no-go stimuli. These findings point to a more prudent strategy when using attentional resources in aging that allows reducing the false-alarm rate in tasks producing a tendency for automatic responding.

Differential effects of mind-wandering and visual distraction on age-related changes in neuro-electric brain activity and variability

Optimal performance in many tasks requires minimizing the impact of both visual distractors in the environment and distracting internal thoughts (i.e., mind-wandering). Prior research has indicated that older adults are disproportionately affected by the presence of visual distractors compared to young adults, but are not excessively affected by distracting thoughts. Yet an explanation for these dissociable effects remains elusive. In the current study, we assessed age-related differences in event-related potentials and neural variability associated with internal distraction and visual distractors in a go/no-go task. Compared to young adults, older adults showed an increased visual distraction cost in mean reaction time (RT) and RT variability but a reduction in internal distraction frequency and a reduced internal distraction cost on go accuracy and RT variability. Visual distraction and internal distraction were associated with opposite patterns of behavioral and neural effects. Behaviorally, across age groups, internal distraction was associated with more no-go errors whereas visual distraction was associated with reduced no-go errors. Across groups, internal distraction was associated with decreased P3 amplitude, whereas visual distraction was associated with increased P3 amplitude. In addition, internal distraction was associated with an increase in neural variability (more so in young versus older adults), while visual distraction was associated with a reduction in variability in young adults only. We suggest that the opposing effects of the two distractor types on behavioral and neural measures occur because visual distraction is associated with increased attentional resources devoted to the task to overcome visual interference whereas internal distraction is associated with decreased attentional resources devoted to the task. Moreover, older adults exhibited reduced flexibility of neural variability as a function of both distractor types, which may correspond to a diminished ability to up-regulate attention in the face of visual distraction and a diminished shift in attention away from the task during internal distraction.

Cognitive Abilities of Dogs with Mucopolysaccharidosis I: Learning and Memory

Mucopolysaccharidosis I (MPS I) results from a deficiency of a lysosomal enzyme, alpha-L-iduronidase (IDUA). IDUA deficiency leads to glycosaminoglycan (GAG) accumulation resulting in cellular degeneration and multi-organ dysfunction. The primary aims of this pilot study were to determine the feasibility of cognitive testing MPS I affected dogs and to determine their non-social cognitive abilities with and without gene therapy. Fourteen dogs were tested: 5 MPS I untreated, 5 MPS I treated, and 4 clinically normal. The treated group received intrathecal gene therapy as neonates to replace the IDUA gene. Cognitive tests included delayed non-match to position (DNMP), two-object visual discrimination (VD), reversal learning (RL), attention oddity (AO), and two-scent discrimination (SD). Responses were recorded as correct, incorrect, or no response, and analyzed using mixed effect logistic regression analysis. Significant differences were not observed among the three groups for DNMP, VD, RL, or AO. The MPS I untreated dogs were excluded from AO testing due to failing to pass acquisition of the task, potentially representing a learning or executive function deficit. The MPS I affected group (treated and untreated) was significantly more likely to discriminate between scents than the normal group, which may be due to an age effect. The normal group was comprised of the oldest dogs, and a mixed effect logistic model indicated that older dogs were more likely to respond incorrectly on scent discrimination. Overall, this study found that cognition testing of MPS I affected dogs to be feasible. This work provides a framework to refine future cognition studies of dogs affected with diseases, including MPS I, in order to assess therapies in a more comprehensive manner.

Age doesn't matter much: hybrid visual and memory search is preserved in older adults

We tested younger and older observers' attention and long-term memory functions in a "hybrid search" task, in which observers look through visual displays for instances of any of several types of targets held in memory. Apart from a general slowing, search efficiency did not change with age. In both age groups, reaction times increased linearly with the visual set size and logarithmically with the memory set size, with similar relative costs of increasing load (Experiment 1). We replicated the finding and further showed that performance remained comparable between age groups when familiarity cues were made irrelevant (Experiment 2) and target-context associations were to be retrieved (Experiment 3). Our findings are at variance with theories of cognitive aging that propose age-specific deficits in attention and memory. As hybrid search resembles many real-world searches, our results might be relevant to improve the ecological validity of assessing age-related cognitive decline.

Textual cohesion in oral narrative and procedural discourse: the effects of ageing and cognitive skills

BACKGROUND

Knowledge of the discourse performance of non-brain-damaged individuals is critical not only for its differentiation from disordered expression but also for more accurate models of ageing and communication. The effect of ageing and cognitive skills on the cohesive adequacy of discourse has, until now, presented a confusing and ambiguous picture.

AIMS

To examine comprehensively the effects of both age and cognitive skills on the discourse cohesion of 32 non-brain-damaged males divided into four age groups.

METHODS & PROCEDURES

A large body of narrative and procedural samples (394 samples) was elicited from the participants. Their cognitive skills were determined using three tests, whilst their discourse cohesion was analyzed and correlated with the cognitive test results.

OUTCOMES & RESULTS

This extensive investigation of ageing effects on discourse cohesion and their relationship to cognitive behaviour did not provide neat generalizable results. It showed that ageing significantly increases the number of cohesive errors and reduces the quantity of referential ties in picture-sequence narratives. The changes with age were limited to two aspects of cohesion and not linear across age groups. The participants' cognitive skills declined with age. Correlations between some cognitive tests and certain cohesive changes suggest co-occurring deficits rather than a causal explanation of cohesive decline with age.

CONCLUSIONS & IMPLICATIONS

With ageing there are increased cohesive errors and decreased referential ties, co-occurring with declining cognitive skills. This study yields important guidance for future research, suggesting that picture-sequence narrative is the most effective tool for clinical evaluation of discourse, but also that findings from one discourse sample may be misleading.

Aging of the frontal lobe

Healthy aging is associated with numerous deficits in cognitive function, which have been attributed to changes within the prefrontal cortex (PFC). This chapter summarizes some of the most prominent cognitive changes associated with age-related alterations in the anatomy and physiology of the PFC. Specifically, aging of the PFC results in deficient aspects of cognitive control, including sustained attention, selective attention, inhibitory control, working memory, and multitasking abilities. Yet, not all cognitive functions associated with the PFC exhibit age-related declines, such as arithmetic, comprehension, emotion perception, and emotional control. Moreover, not all older adults exhibit declines in cognition. Multiple life-course and lifestyle factors, as well as genetics, play a role in the trajectory of cognitive performance across the life span. Thus many adults retain cognitive function well into advanced age. Moreover, the brain remains plastic throughout life and there is increasing evidence that most age-related declines in cognition can be remediated by various methods such as physical exercise, cognitive training, or noninvasive brain stimulation. Overall, because cognitive aging is associated with numerous life-course and lifestyle factors, successful aging likely begins in early life, while maintaining cognition or remediating declines is a life-long process.

Applicability of the Test of Variables of Attention - T.O.V.A in Brazilian adults

The functioning of attention is complex, a primordial function in several cognitive processes and of great interest to neuropsychology. The Test of Variables of Attention (T.O.V.A) is a continuous computerized performance test that evaluates some attention components such as response time to a stimulus and errors due to inattention and impulsivity.

Effect of Age and Dietary Intervention on Discrimination Learning in Pet Dogs

Aging is associated with a decline in cognitive functions such as learning, memory, attention, cognitive flexibility, and executive functions. Recent evidence indicates that interventions such as exercise, diet and cognitive training can be used to reduce the rate of age-dependent cognitive decline. In this study, we examined the changes in discrimination learning in older pet dogs, tested whether a dietary intervention counteracts a potential decline in learning and evaluated the influence of lifelong training on learning speed and cognitive flexibility. We included 115 pet dogs (>6 years) of 30 different breeds into one of two treatment groups: either a diet enriched with antioxidants, docosahexaenoic acid (DHA), Phosphatidylserine and tryptophan or a control diet for 1 year. Lifelong training was calculated for each dog using a questionnaire where owners filled their dog’s training experiences over years. Dogs were trained to discriminate different pictures at the start of the dietary intervention using a touch screen methodology. After 1 year of dietary intervention, they were tested on a main picture discrimination task where they were confronted with a discrimination of four new pictures. We used the total number of sessions needed to reach learning criterion as a measure of learning speed and the rate of correction trials as a measure of deficit in learning from feedback/cognitive flexibility. In the main discrimination task, we found an influence of neither age nor diet on the speed of learning and deficit in learning from feedback. We did not find any influence of lifelong training either. The null findings were further corroborated by Bayesian statistics. The null findings might be due to the fact that pet dogs live in a stimulating environment which may reduce the rate of cognitive decline and hinder finding an age or diet effect. Also, the similarity between the training and the main discrimination task might have made the main task too easy for the animals to solve. Further studies are warranted to assess the effect of enriched diets on pet dogs using tasks that measure cognitive functions with a higher sensitivity.

Connectome-based models predict attentional control in aging adults

There are well-characterized age-related differences in behavioral and neural responses to tasks of attentional control. However, there is also increasing recognition of individual variability in the process of neurocognitive aging. Using connectome-based predictive modeling, a method for predicting individual-level behaviors from whole-brain functional connectivity, a sustained attention connectome-based prediction model (saCPM) has been derived in young adults. The saCPM consists of two large-scale functional networks: a high-attention network whose strength predicts better attention and a low-attention network whose strength predicts worse attention. Here we examined the generalizability of the saCPM for predicting inhibitory control in an aging sample. Forty-two healthy young adults (n = 21, ages 18-30) and older adults (n = 21, ages 60-80) performed a modified Stroop task, on which older adults exhibited poorer performance, indexed by higher reaction time cost between incongruent and congruent trials. The saCPM generalized to predict reaction time cost across age groups, but did not account for age-related differences in performance. Exploratory analyses were conducted to characterize the effects of age on functional connectivity and behavior. We identified subnetworks of the saCPM that exhibited age-related differences in strength. The strength of two low-attention subnetworks, consisting of frontoparietal, medial frontal, default mode, and motor nodes that were more strongly connected in older adults, mediated the effect of age group on performance. These results support the saCPM's ability to capture attention-related patterns reflected in each individual's functional connectivity signature across both task context and age. However, older and younger adults exhibit functional connectivity differences within components of the saCPM networks, and it is these connections that better account for age-related deficits in attentional control.

Healthy Aging and Dementia: Two Roads Diverging in Midlife?

Dementia, particularly Alzheimer’s disease (AD), is a growing pandemic that presents profound challenges to healthcare systems, families, and societies throughout the world. By 2050, the number of people living with dementia worldwide could almost triple, from 47 to 132 million, with associated costs rising to $3 trillion. To reduce the future incidence of dementia, there is an immediate need for interventions that target the disease process from its earliest stages. Research programs are increasingly starting to focus on midlife as a critical period for the beginning of AD-related pathology, yet the indicators of the incipient disease process in asymptomatic individuals remain poorly understood. We address this important knowledge gap by examining evidence for cognitive and structural brain changes that may differentiate, from midlife, healthy aging and pathological AD-related processes. This review crystallizes emerging trends for divergence between the two and highlights current limitations and opportunities for future research in this area.

Tracking behavioral and neural fluctuations during sustained attention: A robust replication and extension

Novel paradigms have allowed for more precise measurements of sustained attention ability and fluctuations in sustained attention over time, as well as the neural basis of fluctuations and lapses in performance. However, in recent years, concerns have arisen over the replicability of neuroimaging studies and psychology more broadly, particularly given the typically small sample sizes. One recently developed paradigm, the gradual-onset continuous performance task (gradCPT) has been validated behaviorally in large samples of participants. Yet neuroimaging studies investigating the neural basis of performance on this task have only been collected in small samples. The present study completed both a robust replication of the original neuroimaging findings and extended previous results from the gradCPT task using a large sample of 140 Veteran participants. Results replicate findings that fluctuations in attentional stability are tracked over time by BOLD activity in task positive (e.g., dorsal and ventral attention networks) and task negative (e.g., default network) regions. Extending prior results, we relate this coupling between attentional stability and on-going brain activity to overall sustained attention ability and demonstrate that this coupling strength, along with across-network coupling, could be used to predict individual differences in performance. Additionally, the results extend previous findings by demonstrating that temporal dynamics across the default and dorsal attention networks are associated with lapse-likelihood on subsequent trials. This study demonstrates the reliability of the gradCPT, and underscores the utility of this paradigm in understanding attentional fluctuations, as well as individual variation and deficits in sustained attention.

The importance of sustained attention in early Alzheimer's disease

INTRODUCTION

There is conflicting evidence regarding impairment of sustained attention in early Alzheimer's disease (AD). We examine whether sustained attention is impaired and predicts deficits in other cognitive domains in early AD.

METHODS

Fifty-one patients with early AD (MMSE > 18) and 15 healthy elderly controls were recruited. The sustained attention to response task (SART) was used to assess sustained attention. A subset of 25 patients also performed tasks assessing general cognitive function (ADAS-Cog), episodic memory (Logical memory scale, Paired Associates Learning), executive function (verbal fluency, grammatical reasoning) and working memory (digit and spatial span).

RESULTS

AD patients were significantly impaired on the SART compared to healthy controls (total error β = 19.75, p = 0.027). SART errors significantly correlated with MMSE score (Spearman's rho = -0.338, p = 0.015) and significantly predicted deficits in ADAS-Cog (β = 0.14, p = 0.004).

DISCUSSIONS

Patients with early AD have significant deficits in sustained attention, as measured using the SART. This may impair performance on general cognitive testing, and therefore should be taken into account during clinical assessment, and everyday management of individuals with early AD. Copyright © 2016 John Wiley & Sons, Ltd.

The effects of age on visual expertise for print

Progressive visual processing decline is a known factor in aging. The present study investigates the evolution of visual expertise for printed stimuli with aging. Fifty-five participants of increasing age (20-30, 40-50, 60-70, 75-85years old) were recruited. Behavioral and EEG data were collected during a lexical decision task, in which words and symbol strings were presented. Analyses of EEG data focused mainly on three major points: visual expertise for print, automatization of the expertise and differences in attentional demand between the processing of words and symbols. Results indicated a preservation of visual expertise with age, with larger N170 amplitude for words than for symbols. Moreover, a decrease in stimulus processing speed was observed as a function of age. No difference in attentional demand as a function of stimulus was observed.

On the preservation of vigilant attention to semantic information in healthy aging

Despite decades of research on younger adults, little is known about the way in which vigilant attention is affected by healthy aging, and the small body of work that does exist has yielded mixed findings. Prior examinations of aging and vigilant attention have focused almost exclusively on sensory/perceptual tasks despite the fact that many real-world vigilance tasks are semantic in nature and it has been shown that older adults exhibit memory and attention deficits in semantic tasks in other domains. Here, we present the first empirical investigation of vigilant attention to verbal stimuli in healthy normal aging. In Experiment 1 we find that older adults are just as able as younger adults to identify critical targets defined by category membership (both overall and over time). In Experiment 2, we increase the difficulty of the task by changing the target category from one block to the next, but again find no age-group effects in accuracy. Response time data, however, show that older adults respond more slowly and subjective ratings indicate that older adults experience higher workload and arousal compared to their younger counterparts. The practical as well as theoretical implications of these findings are discussed.

Recent theoretical, neural, and clinical advances in sustained attention research

Models of attention often distinguish among attention subtypes, with classic models separating orienting, switching, and sustaining functions. Compared with other forms of attention, the neurophysiological basis of sustaining attention has received far less notice, yet it is known that momentary failures of sustained attention can have far-ranging negative effects in healthy individuals, and lasting sustained attention deficits are pervasive in clinical populations. In recent years, however, there has been increased interest in characterizing moment-to-moment fluctuations in sustained attention, in addition to the overall vigilance decrement, and understanding how these neurocognitive systems change over the life span and across various clinical populations. The use of novel neuroimaging paradigms and statistical approaches has allowed for better characterization of the neural networks supporting sustained attention and has highlighted dynamic interactions within and across multiple distributed networks that predict behavioral performance. These advances have also provided potential biomarkers to identify individuals with sustained attention deficits. These findings have led to new theoretical models explaining why sustaining focused attention is a challenge for individuals and form the basis for the next generation of sustained attention research, which seeks to accurately diagnose and develop theoretically driven treatments for sustained attention deficits that affect a variety of clinical populations.

Aging of Attentiveness in Border Collies and Other Pet Dog Breeds: The Protective Benefits of Lifelong Training

Aging of attentiveness affects cognitive functions like perception and working memory, which can seriously impact communication between dogs and humans, potentially hindering training and cooperation. Previous studies have revealed that aged laboratory beagles and pet Border collies (BC) show a decline in selective attention. However, much less is known about the aging of attentiveness in pet dogs in general rather than in specific breeds. Using 185 pet dogs (75 BC and 110 dogs of other breeds) divided into three age groups [late adulthood (6- < 8 year), senior (8- < 10 year) and geriatric (≥10 year)], we assessed the progress of aging of attentional capture, sustained and selective attention in older dogs in order to explore if prior results in BC are generalizable and to evaluate the influence of lifelong training on measures of attention. Each dog’s lifelong training score (ranging from 0 to 52) was calculated from a questionnaire filled in by the owners listing what kinds of training the dog participated in during its entire life. Dogs were tested in two tasks; the first, measuring attentional capture and sustained attention toward two stimuli (toy and human); and the second, measuring selective attention by means of clicker training for eye contact and finding food on the floor. In the first task, results revealed a significant effect of age but no effect of lifelong training on latency to orient to the stimuli. Duration of looking decreased with age and increased with lifelong training. In the second task, while lifelong training decreased the latency of dogs to form eye contact, aged dogs needed longer to find food. BC did not differ from other dogs in any measures of attention except latency to find food. In conclusion, aged dogs showed a decline in attentional capture and sustained attention demonstrating that these tests are sensitive to detect aging of attentiveness in older pet dogs. Importantly, selective attention remained unchanged with age and lifelong training seemed to delay or reduce the aging of attentiveness, further highlighting the importance of lifelong training in retaining general cognitive functions.

BOLD neurovascular coupling does not change significantly with normal aging

Studies of cognitive function that compare the blood oxygenation level dependent (BOLD) signal across age groups often require the assumption that neurovascular coupling does not change with age. Tests of this assumption have produced mixed results regarding the strength of the coupling and its relative time course. Using deconvolution, we found that age does not have a significant effect on the time course of the hemodynamic impulse response function or on the slope of the BOLD versus stimulus duration relationship. These results suggest that in cognitive studies of healthy aging, group differences in BOLD activation are likely due to age-related changes in cognitive-neural interactions and information processing rather than to impairments in neurovascular coupling. Hum Brain Mapp 38:3538-3551, 2017. © 2017 Wiley Periodicals, Inc.

The reaction times of drivers aged 20 to 80 during a divided attention driving

OBJECTIVE

Many studies addressing age-related changes in driving performance focus on comparing young vs. older drivers, which might lead to the biased conclusion that driving performance decreases only after the age of 65. The main aim of the study was to show that changes in driving performance are progressive throughout the adult years.

METHODS

A sample of 351 drivers aged 20 to 80 was assessed for their reaction times while driving between road cones. The drivers were exposed to 2 conditions varying according to task complexity. In single task conditions, the drivers performed a full stopping maneuver at a given signal; in dual task conditions, the drivers were distracted before the signal for stopping maneuver was triggered. Reaction times were compared across conditions and age groups.

RESULTS

The results showed that both reaction times and variability of driving performance increased progressively between the ages of 20 and 80. The increase in both reaction times and variability was greater in the complex task condition. The high-performing quarter of elderly drivers performed equally well or better than younger drivers did.

CONCLUSIONS

The data clearly supported the claim that driving performance changes steadily across age groups: both mean reaction time and interindividual variability progressively increase with age. In addition, a significant group of older drivers was identified who did not show the expected age-related decrease in performance. The findings have important implications, suggesting that in relation to driving, aging is a progressive phenomenon and may lead to variety of driving performance; age-related studies of driving performance should put more emphasis on investigating changes across the whole driver age range rather than only comparing younger and older drivers.

Sustained Attention Across the Life Span in a Sample of 10,000: Dissociating Ability and Strategy

Normal and abnormal differences in sustained visual attention have long been of interest to scientists, educators, and clinicians. Still lacking, however, is a clear understanding of how sustained visual attention varies across the broad sweep of the human life span. In the present study, we filled this gap in two ways. First, using an unprecedentedly large 10,430-person sample, we modeled age-related differences with substantially greater precision than have prior efforts. Second, using the recently developed gradual-onset continuous performance test (gradCPT), we parsed sustained-attention performance over the life span into its ability and strategy components. We found that after the age of 15 years, the strategy and ability trajectories saliently diverge. Strategy becomes monotonically more conservative with age, whereas ability peaks in the early 40s and is followed by a gradual decline in older adults. These observed life-span trajectories for sustained attention are distinct from results of other life-span studies focusing on fluid and crystallized intelligence.

Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population

Curcumin possesses many properties which may prevent or ameliorate pathological processes underlying age-related cognitive decline, dementia or mood disorders. These benefits in preclinical studies have not been established in humans. This randomized, double-blind, placebo-controlled trial examined the acute (1 and 3 h after a single dose), chronic (4 weeks) and acute-on-chronic (1 and 3 h after single dose following chronic treatment) effects of solid lipid curcumin formulation (400 mg as Longvida®) on cognitive function, mood and blood biomarkers in 60 healthy adults aged 60-85. One hour after administration curcumin significantly improved performance on sustained attention and working memory tasks, compared with placebo. Working memory and mood (general fatigue and change in state calmness, contentedness and fatigue induced by psychological stress) were significantly better following chronic treatment. A significant acute-on-chronic treatment effect on alertness and contentedness was also observed. Curcumin was associated with significantly reduced total and LDL cholesterol and had no effect on hematological safety measures. To our knowledge this is the first study to examine the effects of curcumin on cognition and mood in a healthy older population or to examine any acute behavioral effects in humans. Results highlight the need for further investigation of the potential psychological and cognitive benefits of curcumin in an older population.

Sustained attention failures are primarily due to sustained cognitive load not task monotony

We conducted two studies using a modified sustained attention to response task (SART) to investigate the developmental process of SART performance and the role of cognitive load on performance when the speed-accuracy trade-off is controlled experimentally. In study 1, 23 participants completed the modified SART (target stimuli location was not predictable) and a subjective thought content questionnaire 4 times over the span of 4 weeks. As predicted, the influence of speed-accuracy trade-off was significantly mitigated on the modified SART by having target stimuli occur in unpredictable locations. In study 2, 21 of the 23 participants completed an abridged version of the modified SART with a verbal free-recall memory task. Participants performed significantly worse when completing the verbal memory task and SART concurrently. Overall, the results support a resource theory perspective with concern to errors being a result of limited mental resources and not simply mindlessness per se.

Questions of age differences in interference control: When and how, not if?

Declines in the control of attention and working memory are often considered a core feature of cognitive aging. In particular, the idea that older adults are differentially vulnerable to interference from irrelevant information has played an important but sometimes controversial role in guiding research. However, age differences in performance on measures of interference control are sometimes surprisingly small, and in some cases (e.g., mind-wandering and sustained attention), older adults perform better than young adults. Are age differences in interference control more myth than reality? We consider the evidence in light of neurocognitive frameworks that acknowledge the sometimes complex interactions between age-related declines and compensation. When operations can be performed within the focus of attention, age differences in interference control may be more easily detected in neural measures than behavioral ones, whereas behavioral differences are more likely to occur in tasks that require retrieval of information into the focus. Our analysis suggests that age differences in interference control have multiple sources, but also offer multiple opportunities for compensation and intervention. This article is part of a Special Issue entitled SI: Memory & Aging.

A neuropsychological instrument measuring age-related cerebral decline in older drivers: development, reliability, and validity of MedDrive

When facing age-related cerebral decline, older adults are unequally affected by cognitive impairment without us knowing why. To explore underlying mechanisms and find possible solutions to maintain life-space mobility, there is a need for a standardized behavioral test that relates to behaviors in natural environments. The aim of the project described in this paper was therefore to provide a free, reliable, transparent, computer-based instrument capable of detecting age-related changes on visual processing and cortical functions for the purposes of research into human behavior in computational transportation science. After obtaining content validity, exploring psychometric properties of the developed tasks, we derived (Study 1) the scoring method for measuring cerebral decline on 106 older drivers aged ≥70 years attending a driving refresher course organized by the Swiss Automobile Association to test the instrument's validity against on-road driving performance (106 older drivers). We then validated the derived method on a new sample of 182 drivers (Study 2). We then measured the instrument's reliability having 17 healthy, young volunteers repeat all tests included in the instrument five times (Study 3) and explored the instrument's psychophysical underlying functions on 47 older drivers (Study 4). Finally, we tested the instrument's responsiveness to alcohol and effects on performance on a driving simulator in a randomized, double-blinded, placebo, crossover, dose-response, validation trial including 20 healthy, young volunteers (Study 5). The developed instrument revealed good psychometric properties related to processing speed. It was reliable (ICC = 0.853) and showed reasonable association to driving performance (R (2) = 0.053), and responded to blood alcohol concentrations of 0.5 g/L (p = 0.008). Our results suggest that MedDrive is capable of detecting age-related changes that affect processing speed. These changes nevertheless do not necessarily affect driving behavior.

Detecting everyday action deficits in Alzheimer's disease using a nonimmersive virtual reality kitchen

Alzheimer's disease (AD) causes impairments affecting instrumental activities of daily living (IADL). Transdisciplinary research in neuropsychology and virtual reality has fostered the development of ecologically valid virtual tools for the assessment of IADL, using simulations of real life activities. Few studies have examined the benefits of this approach in AD patients. Our aim was to examine the utility of a non-immersive virtual coffee task (NI-VCT) for assessment of IADL in these patients. We focus on the assessment results obtained from a group of 24 AD patients on a task designed to assess their ability to prepare a virtual cup of coffee, using a virtual coffee machine. We compared performance on the virtual task to an identical daily living task involving the actual preparation of a cup of coffee, as well as to global cognitive, executive, and caregiver-reported IADL functioning. Relative to 32 comparable, healthy elderly (HE) controls, AD patients performed worse than HE controls on all tasks. Correlation analyses revealed that NI-VCT measures were related to all other neuropsychological measures. Moreover, regression analyses demonstrated that performance on the NI-VCT predicted actual task performance and caregiver-reported IADL functioning. Our results provide initial support for the utility of our virtual kitchen for assessment of IADL in AD patients.

Investigating sustained attention ability in the elderly by using two different approaches: inhibiting ongoing behavior versus responding on rare occasions

Previous studies on sustained attention ability in the elderly produced inconsistent results. The aim of this study was to evaluate sustained attention performance in younger and older individuals by using, in a within-subjects design, two versions of the same task (the sustained attention to response task, SART) in which only in the response mode differed: in a traditionally formatted task (TFT), subjects had to respond to rare targets, and in a Go/No-Go task they had to withhold response to rare targets. Results showed that in the TFT SART only the older group exhibited a vigilance decrement. On the contrary, only young individuals showed a vigilance decrement in the Go/No-Go SART. These results showed that older individuals, who also reported less mind wandering and a higher level of motivation, exhibited preserved sustained attention ability in the Go/No-Go SART, which could be explained by increased engagement of cognitive control mechanisms in this population. The discrepancy in performance depending on the approach used also underlines the need for further studies on the nature of attention failures and their underlying mechanisms.