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Wang Y, Zhong M, Li Y, Liu Y, Tong B, Qiu J, Chen S. Association Between Hearing Loss, Asymmetric Hearing, and Postural Instability. Ear Hear 2024; 45:827-836. [PMID: 38351499 DOI: 10.1097/aud.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Recent studies have suggested that older adults with hearing loss (HL) are at a greater risk of postural instability than those with normal hearing. However, little is known regarding this association in middle-aged individuals. The relationships between HL laterality, asymmetric hearing, and posture control are similarly unclear. The purpose of this study was to investigate the effects of hearing status on postural control and to explore the dose-response relationship between the hearing threshold and postural instability risk in middle-aged adults. DESIGN This cross-sectional study included 1308 participants aged 40 to 69 years with complete audiometric and standing balance function data from the 2001-2004 National Health and Nutrition Examination Survey. Speech-frequency HL was defined as a pure-tone average at 0.5, 1, 2, and 4 kHz of >25 dB in the better-hearing ear; high-frequency HL was defined as a pure-tone average at 3, 4, and 6 kHz of >25 dB. Asymmetric hearing was defined as a difference in the pure-tone average >15 dB between ears. Postural instability was defined as participants ending the modified Romberg test in condition 4. RESULTS After adjustment for sociodemographic variables, lifestyle, and comorbidities, speech-frequency HL, except for unilateral HL, was associated with increased postural instability (mild HL: odds ratio [OR], 2.33; 95% confidence interval [CI], 1.25-4.35; moderate-to-severe HL: OR, 3.59; 95% CI, 1.61-8.03). Compared with individuals with normal bilateral hearing, participants with bilateral HL also showed a higher risk of postural instability (OR, 2.88; 95% CI, 1.61-5.14). The OR for postural instability among participants with asymmetric hearing compared with those with symmetric hearing was 2.75 (95% CI, 1.37-5.52). Furthermore, each 10 dB increase in the speech-frequency hearing threshold was associated with a 44% higher risk of postural instability. CONCLUSIONS Hearing loss is associated with poorer postural control. Individuals with asymmetric hearing have a higher postural instability risk compared with those with symmetric hearing. Further studies are needed to confirm these findings and the causality. Moreover, future studies are warranted to assess whether hearing aids are beneficial for the restoration of impaired balance functions.
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Affiliation(s)
- Yang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Otorhinolaryngology-Head and Neck Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, P.R. China
| | - Mei Zhong
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yifan Li
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yehai Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Busheng Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jianxin Qiu
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Otorhinolaryngology-Head and Neck Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, P.R. China
| | - Shanwen Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
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Wunderlich A, Wollesen B, Asamoah J, Delbaere K, Li K. The impact of cognitive-motor interference on balance and gait in hearing-impaired older adults: a systematic review. Eur Rev Aging Phys Act 2024; 21:17. [PMID: 38914940 PMCID: PMC11194914 DOI: 10.1186/s11556-024-00350-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 05/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Hearing impairments are a rising burden in our aging society. Hearing loss is associated with reduced cognitive performance as well as decrements in balance and gait. Therefore, impaired hearing affects also dual tasking (DT). The aim of this review is to summarize the evidence for DT performance decrements of older adults with hearing impairments during maintaining balance or walking. METHODS The systematic literature research according to PRISMA guidelines was conducted using MEDLINE, APA Psych-Info, and Web of Science. Inclusion criteria were: Independent living older people ≥ 60 years with hearing impairments, use of a DT paradigm to test hearing impaired older adults within a balance or walking condition. RESULTS N = 57 studies were found within the databases. Eight studies were included (N = 456 participants (58% women), including n = 200 older hearing-impaired persons with different levels of hearing loss). Most of the included studies oriented their inclusion criteria for hearing-impairments at thresholds for mild hearing loss with Pure Tone Average (0.5-4 kHz) ≥ 25 and < 40 dB. Three of the studies focused on DT balance performance and five used DT walking comparing participants with and without hearing loss. For DT balance and gait performance, higher decrements for the hearing-impaired group were observed compared to healthy older adults. Performance decrements were accompanied by reduced compensatory strategies in balance performance. CONCLUSION More pronounced decrements in DT performance were observed for participants with hearing impairments compared to those without. This implies that hearing-impaired older adults might need specific interventions to reduce the cognitive-motor interference (CMI) to maintain balance control or walking stability in daily situations that require managing of cognitive and motor tasks simultaneously. However, taking all results into account the underlying mechanisms of CMI for this target group needs to be further examined. TRIAL REGISTRATION This review was registered at Prospero with the ID CRD42022340232.
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Affiliation(s)
- Anna Wunderlich
- Technische Universität Berlin, Chair of Biopsychology and Neuroergonomics, Berlin, Germany.
| | - Bettina Wollesen
- Faculty of Psychology and Human Movement Science, Institute for Human Movement Science, Universität Hamburg, Hamburg, Germany
| | - Janek Asamoah
- Faculty of Psychology and Human Movement Science, Institute for Human Movement Science, Universität Hamburg, Hamburg, Germany
| | - Kim Delbaere
- Neuroscience Research Australia (NeuRA) Falls, Balance and Injury Research Centre, Sydney, NSW, Australia
- Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Karen Li
- Department of Psychology, Concordia University, Montreal, Canada
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Usta Ozdemir H, Kitis A, Ardıc FN. Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study. J Aging Phys Act 2024:1-12. [PMID: 38521052 DOI: 10.1123/japa.2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 12/28/2023] [Accepted: 01/20/2024] [Indexed: 03/25/2024]
Abstract
We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.
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Affiliation(s)
- Hande Usta Ozdemir
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Ali Kitis
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Fazıl Necdet Ardıc
- Department of Otorhinolaryngology, Medicine Faculty, Pamukkale University, Denizli, Turkey
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Downey R, Gagné N, Mohanathas N, Campos JL, Pichora-Fuller KM, Bherer L, Lussier M, Phillips NA, Wittich W, St-Onge N, Gagné JP, Li K. At-home computerized executive-function training to improve cognition and mobility in normal-hearing adults and older hearing aid users: a multi-centre, single-blinded randomized controlled trial. BMC Neurol 2023; 23:378. [PMID: 37864139 PMCID: PMC10588173 DOI: 10.1186/s12883-023-03405-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Hearing loss predicts cognitive decline and falls risk. It has been argued that degraded hearing makes listening effortful, causing competition for higher-level cognitive resources needed for secondary cognitive or motor tasks. Therefore, executive function training has the potential to improve cognitive performance, in turn improving mobility, especially when older adults with hearing loss are engaged in effortful listening. Moreover, research using mobile neuroimaging and ecologically valid measures of cognition and mobility in this population is limited. The objective of this research is to examine the effect of at-home cognitive training on dual-task performance using laboratory and simulated real-world conditions in normal-hearing adults and older hearing aid users. We hypothesize that executive function training will lead to greater improvements in cognitive-motor dual-task performance compared to a wait-list control group. We also hypothesize that executive function training will lead to the largest dual-task improvements in older hearing aid users, followed by normal-hearing older adults, and then middle-aged adults. METHODS A multi-site (Concordia University and KITE-Toronto Rehabilitation Institute, University Health Network) single-blinded randomized controlled trial will be conducted whereby participants are randomized to either 12 weeks of at-home computerized executive function training or a wait-list control. Participants will consist of normal-hearing middle-aged adults (45-60 years old) and older adults (65-80 years old), as well as older hearing aid users (65-80 years old, ≥ 6 months hearing aid experience). Separate samples will undergo the same training protocol and the same pre- and post-evaluations of cognition, hearing, and mobility across sites. The primary dual-task outcome measures will involve either static balance (KITE site) or treadmill walking (Concordia site) with a secondary auditory-cognitive task. Dual-task performance will be assessed in an immersive virtual reality environment in KITE's StreetLab and brain activity will be measured using functional near infrared spectroscopy at Concordia's PERFORM Centre. DISCUSSION This research will establish the efficacy of an at-home cognitive training program on complex auditory and motor functioning under laboratory and simulated real-world conditions. This will contribute to rehabilitation strategies in order to mitigate or prevent physical and cognitive decline in older adults with hearing loss. TRIAL REGISTRATION Identifier: NCT05418998. https://clinicaltrials.gov/ct2/show/NCT05418998.
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Affiliation(s)
- Rachel Downey
- Department of Psychology, Concordia University, Montréal, Québec, Canada.
- PERFORM Centre, Concordia University, Montréal, Québec, Canada.
| | - Nathan Gagné
- Department of Psychology, Concordia University, Montréal, Québec, Canada
| | - Niroshica Mohanathas
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jennifer L Campos
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | | | - Louis Bherer
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Maxime Lussier
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Natalie A Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montréal, Québec, Canada
| | - Nancy St-Onge
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Jean-Pierre Gagné
- École d'orthophonie Et d'audiologie, Université de Montréal, Montréal, Québec, Canada
| | - Karen Li
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
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Gallou-Guyot M, Mandigout S, Marie R, Robin L, Daviet JC, Perrochon A. Feasibility and potential cognitive impact of a cognitive-motor dual-task training program using a custom exergame in older adults: A pilot study. Front Aging Neurosci 2023; 15:1046676. [PMID: 36819724 PMCID: PMC9932982 DOI: 10.3389/fnagi.2023.1046676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Dual-task training may be relevant and efficient in the context of active aging. An issue in training programs lies in enhancing the adherence of participants. This can potentially be improved using games as support. We designed and developed a custom interactive exergame in this way. The objective of this pilot study was to explore the potential use of this exergame and the feasibility of our intervention, including the level of safety and adherence. The result's trends on cognitive and motor capacities, as well as on the level of motivation for physical activity, fear of falling, and quality of life of participants, were also explored. Methods Older adults aged 65 years or older were recruited and realized 30 min of supervised training in groups of 4, 2-3 times a week for 12 weeks. Exercises consisted of incorporated cognitive and motor dual tasks, with an increased difficulty over the weeks. Our program's safety, engagement, attendance, and completion levels were evaluated. Participants' postural control in single-task and dual-task conditions, as well as their performances in mental inhibition, flexibility, working memory, mobility, and postural control, and their levels of motivation for physical activity, fear of falling, and quality of life were also assessed. We realized a per protocol statistical analysis with a p-value set at 0.05. Results Thirty-nine participants (aged 84.6 ± 8.5 years) were recruited. No adverse events, and 89% adherence, 88% attendance, and 87% completion rates were observed. A potentially significant effect of our exergame on working memory in single-task conditions and on the cognitive aspect of dual-task conditions was also observed. We observed no differences in other parameters. Discussion Our exergame seemed feasible and safe and was enjoyed by participants, mainly due to the gamification of our training program. Moreover, our exergame may be efficient for cognitive training in older adults, as well as for the maintenance of motor functions, motivation for physical activity, fear of falling, and quality of life levels. This constitutes the first step for our solution with interesting results that need to be further studied.
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Affiliation(s)
- Matthieu Gallou-Guyot
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,*Correspondence: Matthieu Gallou-Guyot,
| | | | - Romain Marie
- Institut d’Ingénierie Informatique de Limoges, Limoges, France,3iL Ingénieurs, Limoges, France
| | - Louise Robin
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec City, QC, Canada
| | - Jean-Christophe Daviet
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Pôle Neurosciences Tête et Cou, Service de Médecine Physique et de Réadaptation, Hôpital Jean Rebeyrol, CHU Limoges, Limoges, France
| | - Anaick Perrochon
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France
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Foster JI, Williams KL, Timmer BHB, Brauer SG. The Association between Hearing Impairment and Postural Stability in Older Adults: A Systematic Review and Meta-analysis. Trends Hear 2022; 26:23312165221144155. [PMID: 36524292 PMCID: PMC9761226 DOI: 10.1177/23312165221144155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
There is growing evidence linking hearing impairment to higher falls risk through alterations in postural stability, with studies showing mixed results. The primary aim of this systematic review and meta-analysis was to determine the association between hearing impairment and postural instability in older adults, including differences based on severity of hearing impairment. This review was pre-registered in PROSPERO and performed in accordance with PRISMA guidelines across six databases. Primary research on adults aged 60 years and older with hearing loss and an objective measure of postural stability or gait were eligible for inclusion. Methodological quality was assessed using the modified Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Data were analysed using meta-analyses and a narrative synthesis. Inclusion in the meta-analyses required clearly defined audiometrically-assessed hearing impairment, and two subgroups of participants: mild (25-40 dB HL) and moderate to-severe (>40 dB HL) hearing impairment. Twenty-five eligible studies (n = 27,847) were included in the narrative synthesis, with quality ratings ranging from unsatisfactory to very good on the modified NOS. Eight studies were included in the meta-analysis which showed individuals with moderate to-severe hearing impairment were significantly slower on the 5 x sit-to-stand test (mean difference[95%CI] = 0.50 s [0.04, 0.97], p = .03), had a slower gait speed (mean difference[95%CI] = -0.11 s [-0.16, -0.05], p < .001) and had lower total Short Physical Performance Battery scores (mean difference[95%CI] = -0.79[-1.17, -0.41], p < .001) than those with normal hearing. This review provides evidence there is an inverse association between increasing severity of hearing impairment and poorer postural stability across both the meta-analysis and narrative synthesis.
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Affiliation(s)
- Jacinta I. Foster
- University of
Queensland, St Lucia, QLD, Australia,Logan Hospital, Metro South Health
Service, Queensland Health, Meadowbrook, QLD,
Australia,Jacinta I. Foster, School of Health and
Rehabilitation Sciences, University of Queensland, St Lucia, QLD 4067,
Australia.
| | | | - Barbra H. B. Timmer
- University of
Queensland, St Lucia, QLD, Australia,Sonova AG, Stäfa, Switzerland
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da Silva DJF, Torres JL, Ericeira LP, Jardim NYV, da Costa VO, Carvalho JPR, Corrêa PGR, Bento-Torres J, Picanço-Diniz CW, Bento-Torres NVO. Pilates and Cognitive Stimulation in Dual Task an Intervention Protocol to Improve Functional Abilities and Minimize the Rate of Age-Related Cognitive Decline in Postmenopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13333. [PMID: 36293914 PMCID: PMC9603464 DOI: 10.3390/ijerph192013333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED It is already known the effectiveness of Pilates training on cognitive and functional abilities. It is also known that dual-task exercise and cognitive stimuli improve cognition and functional capacity. However, no previous report combined cognitive stimuli and Pilates in dual task and measured its effects on the cognitive and physical performances of postmenopausal women. OBJECTIVE To apply an interventional dual-task (PILATES-COG) protocol and to evaluate its influence on memory, language, and functional physical performances on healthy, community-dwelling postmenopausal older women. METHODS 47 women with amenorrhea for at least 12 months participated in this study. Those allocated on the PILATES-COG group underwent a 12-week, twice a week regimen of 50 min sessions of simultaneous mat Pilates exercise program and cognitive tasks. Cognitive and physical functional performance were assessed. Two-way mixed ANOVA was used for data analysis, and Bonferroni post hoc tests were used for within- and between-group comparisons. RESULTS The PILATES-COG group showed significant improvement after the intervention in semantic verbal fluency (p < 0.001; ηρ² = 0.268), phonological verbal fluency (p < 0.019; ηρ² = 0.143), immediate memory (p < 0.001; ηρ² = 0.258), evocation memory (p < 0.001 ηρ² = 0.282), lower-limb muscle strength (p < 0.001; ηρ² = 0.447), balance (p < 0.001; ηρ² = 0.398), and dual-ask cost (p < 0.05; ηρ² = 0.111) assessments on healthy, community-dwelling postmenopausal older women. CONCLUSION This is the first report of a feasible and effective approach using Pilates and cognitive stimulation in dual task for the reduction of age-related cognitive decline and the improvement of physical functional performance in healthy postmenopausal women.
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Affiliation(s)
- Daniel José Fontel da Silva
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Juliana Lima Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Luiza Pimentel Ericeira
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Naina Yuki Vieira Jardim
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Victor Oliveira da Costa
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Josilayne Patrícia Ramos Carvalho
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Paola Geaninne Reis Corrêa
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - João Bento-Torres
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Cristovam Wanderley Picanço-Diniz
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
| | - Natáli Valim Oliver Bento-Torres
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66075-110, Brazil
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-005, Brazil
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Robledo-Castro C, Castillo-Ossa LF, Corchado JM. Artificial Cognitive Systems Applied in Executive Function Stimulation and Rehabilitation Programs: A Systematic Review. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022; 48:2399-2427. [PMID: 36185593 PMCID: PMC9516512 DOI: 10.1007/s13369-022-07292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/11/2022]
Abstract
This article presents a systematic review of studies on cognitive training programs based on artificial cognitive systems and digital technologies and their effect on executive functions. The aim has been to identify which populations have been studied, the characteristics of the implemented programs, the types of implemented cognitive systems and digital technologies, the evaluated executive functions, and the key findings of these studies. The review has been carried out following the PRISMA protocol; five databases have been selected from which 1889 records were extracted. The articles were filtered following established criteria, to give a final selection of 264 articles that have been used for the purposes of this study in the analysis phase. The findings showed that the most studied populations were school-age children and the elderly. The most studied executive functions were working memory and attentional processes, followed by inhibitory control and processing speed. Many programs were commercial, customizable, gamified, and based on classic tasks. Some more recent initiatives have begun to incorporate user-machine interfaces, robotics, and virtual reality, although studies on their effects remain scarce. The studies recognize multiple benefits of computerized neuropsychological stimulation and rehabilitation programs for executive functions in different age groups, but there is a lack of studies in specific population sectors and with more rigorous research designs. Supplementary Information The online version contains supplementary material available at 10.1007/s13369-022-07292-5.
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Affiliation(s)
- Carolina Robledo-Castro
- Currículo, Universidad y Sociedad Research Group, Universidad del Tolima, Calle 42 1-02, 730006299 Ibagué, Colombia
- Ingeniería del Software Research Group, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, 170001 Manizales, Colombia
| | - Luis F. Castillo-Ossa
- Ingeniería del Software Research Group, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, 170001 Manizales, Colombia
- Inteligencia Artificial Research Group, Universidad de Caldas, Calle 65 26-10, 170002 Manizales, Colombia
- Departamento de Ingeniería Indutrial, Universidad Nacional de Colombia Sede Manizales, Campus La Nubia, 170001 Manizales, Colombia
| | - Juan M. Corchado
- BISITE Research Group, University of Salamanca, Calle Espejo s/n, 37007 Salamanca, Spain
- Air Institute, IoT Digital Innovation Hub, 37188 Salamanca, Spain
- Department of Electronics, Information and Communication, Osaka Institute of Technology, 535-8585 Osaka, Japan
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Al-Yawer F, Bruce H, Li KZH, Pichora-Fuller MK, Phillips NA. Sex-Related Differences in the Associations Between Montreal Cognitive Assessment Scores and Pure-Tone Measures of Hearing. Am J Audiol 2022; 31:220-227. [PMID: 35226818 DOI: 10.1044/2021_aja-21-00131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Hearing loss (HL) is associated with cognitive performance in older adults, including performance on the Montreal Cognitive Assessment (MoCA), a brief cognitive screening test. Yet, despite well-established sex-related differences in both hearing and cognition, very few studies have tested whether there are sex-related differences in auditory-cognitive associations. METHOD In the current cross-sectional retrospective analysis, we examined sex-related differences in hearing and cognition in 193 healthy older adults (M = 69 years, 60% women). Hearing was measured using audiometry (pure-tone average [PTA] of thresholds at 500, 1000, 2000, and 4000 Hz in the worse ear). Cognition was assessed using the MoCA. Additionally, we calculated MoCA scores with hearing-dependent subtests excluded from scoring (MoCA-Modified). RESULTS Men and women did not differ in age, education, or history of depression. Women had better hearing than men. Women with normal hearing were more likely to pass the MoCA compared with their counterparts with HL. In contrast, the likelihood of passing the MoCA did not depend on hearing status in men. Linear regression analysis showed an interaction between sex and PTA in the worse ear. PTAs were significantly correlated with both MoCA and MoCA-Modified scores in women, whereas this was not observed in the men. CONCLUSIONS This study is one of the first to demonstrate significant sex-related differences in auditory-cognitive associations even when hearing-related cognitive test items are omitted. Potential mechanisms underlying these female-specific effects are discussed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19233297.
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Affiliation(s)
- Faisal Al-Yawer
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Centre for Research on Brain, Language & Music (CRBLM), McGill University, Montréal, Québec, Canada
| | - Halina Bruce
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Karen Z. H. Li
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - M. Kathleen Pichora-Fuller
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Department of Psychology, University of Toronto, Mississauga, Ontario, Canada
- Department of Gerontology and Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
- Rotman Research Institute, Toronto, Ontario, Canada
| | - Natalie A. Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Centre for Research on Brain, Language & Music (CRBLM), McGill University, Montréal, Québec, Canada
- Bloomfield Centre for Research in Aging, Lady Davis Institute for Medical Research/Jewish General Hospital/McGill University, Montréal, Québec, Canada
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Yuzlu V, Oguz S, Timurtas E, Aykutoglu E, Polat MG. The Effect of 2 Different Dual-Task Balance Training Methods on Balance and Gait in Older Adults: A Randomized Controlled Trial. Phys Ther 2022; 102:6481184. [PMID: 34972869 DOI: 10.1093/ptj/pzab298] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/21/2021] [Accepted: 11/09/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the effects of integrated and consecutive cognitive dual-task balance training in older adults on balance, fear of falling, and gait performance. METHODS Fifty-eight participants (age >65 years) were randomly assigned to an integrated dual-task training group (IDTT) (n = 29) and consecutive dual-task training group (CDTT) (n = 29). Balance exercises and cognitive tasks were performed simultaneously by the IDTT group and consecutively by the CDTT group for 8 weeks. Balance was assessed using the Berg Balance Scale as a primary outcome measure and the Timed "Up & Go" Test (TUG) (standard-cognitive), fear of falling was assessed using the Tinetti Falls Efficacy Scale, and gait speed was assessed using the 10-Meter Walk Test (10MWT) (under single-task and dual-task conditions). All tests were performed before and after the training. RESULTS There was no difference in group-time interaction in the Berg Balance Scale, TUG-standard, 10MWT-single task, and 10MWT-dual task tests. Group-time interaction was different in the TUG-cognitive and Tinetti Falls Efficacy Scale scores. Also, the effect of time was significantly different in all scales except for the 10MWT-single task in both groups. CONCLUSION At the end of the 8-week training period, the impact of integrated and consecutive dual-task balance training on balance and gait performance in older adults was not statistically significantly different. This study suggests that consecutive dual-task balance training can be used as an alternative method to increase balance performance and gait speed in older adults who cannot perform integrated dual-task activities. IMPACT There were no significant differences between the effects of the 2 dual-task training methods on balance and gait speed, suggesting that the consecutive dual-task balance training method can be used to improve the balance and gait of older adults. CDTT can be performed safely and considered as an alternative method for use in many rehabilitation training programs with older adults who cannot perform simultaneous activities.
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Affiliation(s)
- Volkan Yuzlu
- Darussafaka OYH Physical Therapy and Rehabilitation Center, Maltepe\Istanbul, Turkey
| | - Semra Oguz
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey
| | - Eren Timurtas
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey
| | - Elcin Aykutoglu
- Darussafaka OYH Physical Therapy and Rehabilitation Center, Maltepe\Istanbul, Turkey
| | - M Gulden Polat
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey
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Pupo DA, Small BJ, Deal JA, Armstrong NM, Simonsick EM, Resnick SM, Lin FR, Ferrucci L, Tian Q. Hearing and Mobility in Aging-The Moderating Role of Neuropsychological Function. J Gerontol A Biol Sci Med Sci 2022; 77:2141-2146. [PMID: 35226729 PMCID: PMC9536448 DOI: 10.1093/gerona/glac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In older persons, neuropsychological function, especially sensorimotor function, is strongly associated with mobility. Hearing impairment is related to poor mobility, and we hypothesize that such relationships would be stronger in persons with compromised sensorimotor function than those with preserved sensorimotor function. METHODS We analyzed 601 cognitively normal (Mini-Mental State Examination ≥24 or free of cognitive impairment/dementia) Baltimore Longitudinal Study of Aging participants aged 50 or older with concurrent data on hearing (better ear pure-tone average [PTA]), mobility (6 m usual gait, 400 m endurance walk), and neuropsychological function including attention via Trail Making Test (TMT)-A, executive function via the difference between TMT-A and B, and Digit Symbol Substitution Test, and manual dexterity via Pegboard performance. We examined the association of PTA, each cognitive measure, and their interaction with mobility using multivariable linear regression, adjusted for covariates. RESULTS After covariate adjustment, there were significant interactions between PTA and all cognitive measures in the association with 400 m endurance walking speed as the outcome. There was also a significant interaction between PTA and pegboard nondominant hand performance in the association with 6 m gait as the outcome. In all these cases, the PTA-mobility relationship was stronger among participants with lower cognition. CONCLUSION Impaired hearing more strongly relates to poor mobility among those with compromised neuropsychological performance, especially manual dexterity reflecting the motor-cognitive interface and sensorimotor function, than those with preserved neuropsychological performance. Future longitudinal studies are needed to test whether hearing impairment more strongly predicts mobility decline over time in older persons with compromised neuropsychological function.
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Affiliation(s)
- Daniel A Pupo
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicole M Armstrong
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Eleanor M Simonsick
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland, USA
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Qu Tian
- Address correspondence to: Qu Tian, PhD, MS, Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, 251 Bayview Blvd., Suite 100, RM04B316, Baltimore, MD 21224, USA. E-mail:
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Jones CA, Siever J, Knuff K, Van Bergen C, Mick P, Little J, Jones G, Murphy MA, Kurtz D, Miller H. Walk, Talk and Listen: a pilot randomised controlled trial targeting functional fitness and loneliness in older adults with hearing loss. BMJ Open 2019; 9:e026169. [PMID: 30987987 PMCID: PMC6500300 DOI: 10.1136/bmjopen-2018-026169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Age-related hearing loss (HL) is a prevalent disability associated with loneliness, isolation, declines in cognitive and physical function and premature mortality. Group audiological rehabilitation (GAR) and hearing technologies address communication and cognitive decline. However, the relationship between loneliness, physical function and GAR among older adults with HL has not been studied. OBJECTIVES Explore the impact of a group exercise and socialisation/health education intervention and GAR on physical function and loneliness among older adults with HL. TRIAL DESIGN A Young Men's Christian Association (YMCA)-based, 10-week, single-blind, pilot randomised controlled trial (RCT). PARTICIPANTS Ambulatory adults aged 65 years or older with self-reported HL. INTERVENTIONS Seventy-one participants were screened. Thirty-five were randomised to intervention (strength and resistance exercise, socialisation/health education) and GAR (hearing education, communication strategies, psychosocial support) or control (n=31): GAR only. OUTCOMES Ninety-five per cent of eligible participants were randomised. GAR and exercise adherence rates were 80% and 85%, respectively. 88% of participants completed the study. Intervention group functional fitness improved significantly (gait speed: effect size: 0.57, 30 s Sit to Stand Test: effect size: 0.53). Significant improvements in emotional and social loneliness (effect size: 1.16) and hearing-related quality of life (effect size: 0.76) were related to GAR attendance and poorer baseline hearing-related quality of life. Forty-two per cent of participants increased social contacts outside the study. DISCUSSION Walk, Talk and Listen was feasible and acceptable. Exercise and socialisation/health education improved loneliness and key fitness measures but provided no additional benefit to GAR only for loneliness. This is the first preliminary evidence about the benefits of exercise on fitness and GAR on loneliness among older adults with HL. IMPLICATIONS This pilot trial provides key information on the sample size required for a larger, longer term RCT to determine the enduring effects of this holistic intervention addressing the negative psychosocial and musculoskeletal downstream effects of HL among older adults.
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Affiliation(s)
- Charlotte A Jones
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jodi Siever
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kate Knuff
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | | | - Paul Mick
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jonathan Little
- Health and Exercise Science, University of British Columbia Okanagan Faculty of Health and Social Development, Kelowna, British Columbia, Canada
| | - Gareth Jones
- School of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, Canada
| | - Mary-Ann Murphy
- Social Work/Sociology, University of British Columbia, Kelowna, British Columbia, Canada
| | - Donna Kurtz
- Irving K Barber School of Arts and Social Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Harry Miller
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
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