Aging and longitudinal change in perceptual-motor skill acquisition in healthy adults

Age-related decline of online visuomotor adaptation: a combined effect of deteriorations of motor anticipation and execution

The literature has established that the capability of visuomotor adaptation decreases with aging. However, the underlying mechanisms of this decline are yet to be fully understood. The current study addressed this issue by examining how aging affected visuomotor adaptation in a continuous manual tracking task with delayed visual feedback. To distinguish separate contributions of the declined capability of motor anticipation and deterioration of motor execution to this age-related decline, we recorded and analyzed participants' manual tracking performances and their eye movements during tracking. Twenty-nine older people and twenty-three young adults (control group) participated in this experiment. The results showed that the age-related decline of visuomotor adaptation was strongly linked to degraded performance in predictive pursuit eye movement, indicating that declined capability motor anticipation with aging had critical influences on the age-related decline of visuomotor adaptation. Additionally, deterioration of motor execution, measured by random error after controlling for the lag between target and cursor, was found to have an independent contribution to the decline of visuomotor adaptation. Taking these findings together, we see a picture that the age-related decline of visuomotor adaptation is a joint effect of the declined capability of motor anticipation and the deterioration of motor execution with aging.

Head posture mediates the association of cognition with hand grip and pinch strength in older adults: an examination using structural equation modeling

BACKGROUND

The association of cognition with hand grip and pinch strength has been well-recognized in older adults. The authors sought to explore: (1) associations among forward head posture (FHP), cognition, and hand grip and pinch strength in older adults; and (2) the mediator role of FHP in these pathways using structural equation modeling (SEM).

METHODS

This cross-sectional study included 88 older adults (70.5% male; mean age = 68.75±3.87 years). Cognition was assessed by the Mini-Mental State Examination (MMSE), head posture by the Craniovertebral Angle (CVA) obtained from photographic analysis, hand grip strength by a handheld dynamometer, and pinch strength by a pinch meter. Using the two SEMs, a potential mediator role of the CVA was investigated. While the MMSE was addressed as an independent variable in both models, hand grip and pinch strength were addressed as dependent variables in model 1 and model 2, respectively.

RESULTS

The correlations between the CVA and MMSE (r = 0.310), hand grip strength (r = 0.370), and pinch strength (r = 0.274 to 0.292) were statistically significant (p < 0.001). In addition, significant associations were found between the MMSE and hand grip and pinch strength, ranging from 0.307 to 0.380 (p < 0.001). The mediation analysis showed that the standardized total (β = 0.41, p < 0.001) and indirect (mediated) effects (β = 0.12, p = 0.008) of the MMSE on hand grip strength were significant in model (1) The results were similar for model (2) The standardized total (β = 0.39, p = 0.001) and indirect effects (β = 0.10, p = 0.026) of the MMSE on pinch strength were significant. As a partial mediator in both models, the CVA explained 29% and 26% of the total effect in models 1 and 2, respectively.

CONCLUSIONS

The CVA was associated with the MMSE, hand grip strength, and pinch strength, and CVA partially mediates the association of the MMSE with grip and pinch strength in older adults, indicating that cognition had an effect on grip and pinch strength through an indirect path via head posture. This finding reveals that evaluating head posture and providing corrective therapeutic interventions as needed may be beneficial in reducing the negative impact of decreased cognition on motor functions in older adults.

A study on how concurrent visual feedback affects motor learning of adjustability of grasping force in younger and older adults

In this study, we investigated the differences of the effectiveness from concurrent visual feedback among younger and older adults in learning tasks that require adjustability of grasping force (AGF), as well as the functions related to AGF in each generation. The younger and older adult groups were evaluated for simple visual reaction time as visual-motor speed (VMS) and a 100 g AGF task that reflected the difference between desired performance and actual performance. The main learning task was then practiced using concurrent visual feedback and tested without feedback. The VMS of older adults was slower than that of the younger, and the error in the 100 g AGF task was larger in older adults than in the younger adults. Performance improved from pre-test to retention test in both groups, but the older adult group failed to reach the level of the younger adult group. The results of this study show that concurrent visual feedback is effective for learning the tasks that require AGF in both groups. Indicatively, improvement in performance during practice is insufficient in older people for whom there is a large difference between desired performance and actual performance, or whose VMS is slow.

Effects and Feasibility of a Memory Exergame Training in Older Adults: A Randomized Controlled Trial

Objective: The aim of the study is to assess the feasibility, sustainability, and effectiveness of task-specific memory exergame training on motor-cognitive performance in older adults. Materials and Methods: Fifty older adults (age: 78.8 ± 7.0 years) participated in a randomized controlled trial with a 10-week intervention and 3-month follow-up period. Both the intervention group (IG: n = 29) and control group (CG: n = 21) underwent a once-weekly exercise program, including strength and balance exercises, while the IG performed an additional exergame training, combining dynamic balance with visuospatial memory tasks. Outcome measures were completion time for distinct levels of memory exergame tasks without (condition 1) and with procedural support (condition 2) and (sub)-total game scores documented by a game-specific assessment strategy. Results: Significant improvements in the IG compared with the CG over the intervention period were found for completion times in most of the analyzed levels of condition 1 (P < 0.001-0.047; η_p² = 0.238-0.335) and one level of condition 2 (P < 0.001, η_p² = 0.267), for the subtotal game score of condition 1 (P = 0.002; η_p² = 0.186), and for the total game score (P = 0.005; η_p² = 0.162). Improvements were partially sustained 3 months after training cessation (P = 0.008-0.039, η_p² = 0.095-0.174). Completion rates for initial levels were 86%-98%. No clinical events or safety issues were observed during the training. Conclusion: The study demonstrates that additional memory exergame training effectively, and sustainably, improves performance in complex motor-cognitive tasks involving dynamic balance and visuospatial memory in older adults.

How far can I reach? The perception of upper body action capabilities in Parkinson's disease

Successful interaction within the environment is contingent upon one’s ability to accurately perceive the extent over which they can successfully perform actions, known as action boundaries. Healthy young adults are accurate in estimating their action boundaries and can flexibly update them to accommodate stable changes in their action capabilities. However, there are conditions in which motor abilities are subject to variability over time such as in Parkinson’s disease (PD). PD impairs the ability to perform actions and can lead to variability in perceptual-motor experience, but the effect on the perceptions of their action boundaries remains unknown. This study investigated the influence of altered perceptual-motor experience during PD, on the perceptions of action boundaries for reaching, grasping, and aperture passing. Thirty participants with mild-to-moderate idiopathic PD and 26 healthy older adults provided estimates of their reaching, grasping, and aperture-passing ability. Participants’ estimates were compared with their actual capabilities. There was no evidence that individuals with PD’s perceptions were less accurate than those of healthy controls. Furthermore, there was some evidence for more conservative estimates than seen in young healthy adults in reaching (both groups) and aperture passing (PD group). This suggests that the ability to judge action capabilities is preserved in mild to moderate PD.

Cognitive and Motor Perseveration Are Associated in Older Adults

Aging causes perseveration (difficulty to switch between actions) in motor and cognitive tasks, suggesting that the same neural processes could govern these abilities in older adults. To test this, we evaluated the relation between independently measured motor and cognitive perseveration in young (21.4 ± 3.7 y/o) and older participants (76.5 ± 2.9 y/o). Motor perseveration was measured with a locomotor task in which participants had to transition between distinct walking patterns. Cognitive perseveration was measured with a card matching task in which participants had to switch between distinct matching rules. We found that perseveration in the cognitive and motor domains were positively related in older, but not younger individuals, such that participants exhibiting greater perseveration in the motor task also perseverated more in the cognitive task. Additionally, exposure reduces motor perseveration: older adults who had practiced the motor task could transition between walking patterns as proficiently as naïve, young individuals. Our results suggest an overlap in neural processes governing cognitive and motor perseveration with aging and that exposure can counteract the age-related motor perseveration.

Neural Correlates of Motor Skill Learning Are Dependent on Both Age and Task Difficulty

Although a general age-related decline in neural plasticity is evident, the effects of age on neural plasticity after motor practice are inconclusive. Inconsistencies in the literature may be related to between-study differences in task difficulty. Therefore, we aimed to determine the effects of age and task difficulty on motor learning and associated brain activity. We used task-related electroencephalography (EEG) power in the alpha (8–12 Hz) and beta (13–30 Hz) frequency bands to assess neural plasticity before, immediately after, and 24-h after practice of a mirror star tracing task at one of three difficulty levels in healthy younger (19–24 yr) and older (65–86 yr) adults. Results showed an age-related deterioration in motor performance that was more pronounced with increasing task difficulty and was accompanied by a more bilateral activity pattern for older vs. younger adults. Task difficulty affected motor skill retention and neural plasticity specifically in older adults. Older adults that practiced at the low or medium, but not the high, difficulty levels were able to maintain improvements in accuracy at retention and showed modulation of alpha TR-Power after practice. Together, these data indicate that both age and task difficulty affect motor learning, as well as the associated neural plasticity.

The Impact of Two MMPI-2-Based Models of Personality in Predicting Driving Behavior. Can Demographic Variables Be Disregarded?

The driver’s personality is a key human factor for the assessment of the fitness to drive (FTD), affecting driving decisions and behavior, with consequences on driving safety. No previous study has investigated the effectiveness of Minnesota Multiphasic Personality Inventory (MMPI)-2 scales for predicting the FTD. The present study aimed to compare two MMPI-2-based models of normal and pathological personality traits (i.e., Inventory of Driving-related Personality Traits (IVPE)-MMPI vs. Personality Psychopathology Five (PSY-5) scale) in predicting the cognitive FTD. One hundred young and eighty-seven adult active drivers completed the MMPI-2 questionnaire as a measure of personality and a computerized driving task measuring for resilience of attention (Determination Test (DT)), reaction speed (Reaction Test (RS)), motor speed (MS), and perceptual speed (Adaptive Tachistoscopic Traffic Perception Test (ATAVT)). The effects of age, gender, and education were also controlled. Results showed that the models controlled for demographics overperformed those neglecting them for each driving outcome. A negative effect of age was found on each driving task; the effect of gender, favoring males, was found in both the RS and the MS, and the effect of education was found on the DT and the ATAVT. Concerning personality traits, significant effects were found of sensation seeking (IVPE-MMPI) on each outcome; of anxiety (as a measure of emotional instability; IVPE-MMPI) and introversion (PSY-5) on the measures of MS; and of psychopathic deviation (as a measure of self-control; IVPEMMPI) on the DT. The study confirmed the key role of demographic factors in influencing the FTD, further suggesting the usefulness of some MMPI2-based personality scales in the assessment of driving-related personality determinants.

Spatial Mental Transformation Skills Discriminate Fitness to Drive in Young and Old Adults

Literature on driving research suggests a relationship between cognition and driving performance in older and younger drivers. There is little research on adults and driving, despite them being the largest age cohort behind the wheel. Among the cognitive domains, visuospatial abilities are expected to be highly predictive of driving skills and driving fitness. The relationship between specific spatial mental transformation skills (i.e., object and self-based ones) and driving performance has not yet been examined. The present study aimed to investigate the relationship between overall cognitive functioning, self and object-based spatial mental transformation skills, and driving performance in a sample of younger and older adult drivers. Participants were comprised of one hundred younger and 83 older adult Italian drivers. Participants completed a computerized driving test assessing traffic stress resilience, visual and motor reaction time, and the ability to obtain an overview of the traffic scenario (DT, vRT, mRT, and ATAV respectively in the Shufried®-Vienna Test System-DRIVESC). The Mental Rotation Test (MRT) and the Object Perspective Taking Test (OPT) were administered in order to assess object-based and self-based spatial mental transformation skills. The Montreal Cognitive Assessment Test (MoCA) was administered control for global cognitive functioning. The effects of education and gender were also controlled in the analysis. The results of the present study suggested that: (1) The effect of age, favoring younger participants, was found in DT, vRT, mRT, and ATAVT tests. (2) The effect of global cognitive functioning was found in DT and ATAV tests. (3) The effect of the spatial mental transformation tests was found in DT, vRT (MRT only), and ATAVT (OPT only) tests. Taken together, these results suggest the specific contribution of spatial mental transformation skills in the execution of complex behaviors connected to the fitness to drive. Prospectively, the results of the present study relating spatial mental transformation skills and driving processes may be a valuable source of knowledge for researchers dealing with the relationship between cognitive resources and navigation aids.

Potential and efficiency of statistical learning closely intertwined with individuals' executive functions: a mathematical modeling study

Statistical learning (SL) is essential in enabling humans to extract probabilistic regularities from the world. The ability to accomplish ultimate learning performance with training (i.e., the potential of learning) has been known to be dissociated with performance improvement per amount of learning time (i.e., the efficiency of learning). Here, we quantified the potential and efficiency of SL separately through mathematical modeling and scrutinized how they were affected by various executive functions. Our results showed that a high potential of SL was associated with poor inhibition and good visuo-spatial working memory, whereas high efficiency of SL was closely related to good inhibition and good set-shifting. We unveiled the distinct characteristics of SL in relation to potential and efficiency and their interaction with executive functions.

Failure to Engage Neural Plasticity through Practice of a High-difficulty Task is Accompanied by Reduced Motor Skill Retention in Older Adults

While the difficulty of a motor task can act as a stimulus for learning in younger adults, it is unknown how task difficulty interacts with age-related reductions in motor performance and altered brain activation. We examined the effects of task difficulty on motor performance and used electroencephalography (EEG) to probe task-related brain activation after acquisition and 24-h retention of a mirror star-tracing skill in healthy older adults (N = 36, 65-86 years). The results showed that the difficulty of the motor skill affected both the magnitude of motor skill learning and the underlying neural mechanisms. Behavioral data revealed that practicing a motor task at a high difficulty level hindered motor skill consolidation. The EEG data indicated that task difficulty modulated changes in brain activation after practice. Specifically, a decrease in task-related alpha power in frontal and parietal electrodes was only present after practice of the skill at the low and medium, but not the high difficulty level. Taken together, our findings show that a failure to engage neural plasticity through practice of a high-difficulty task is accompanied by reduced motor skill retention in older adults. The data help us better understand how older adults learn new motor skills and might have implications for prescribing motor skill practice according to its difficulty in rehabilitation settings.

Exploring the relationship between visuospatial function and age-related deficits in motor skill transfer

BACKGROUND

Generalizing learned information from one motor task to another is critical for effective motor rehabilitation. A recent study demonstrated age-related declines in motor skill transfer, yet findings from other motor learning studies suggest that visuospatial impairments may explain such aging effects.

AIMS

The purpose of this secondary analysis was to test whether age-related deficits in motor skill transfer were related to low visuospatial ability.

METHODS

Forty-two participants (mean ± SD age: 72.1 ± 9.9 years) were tested on an upper extremity dexterity task before and after 3 days of training on an upper extremity reaching task. Training and control data have been published previously. Prior to training, global cognitive status and specific cognitive domains (visuospatial/executive, attention, and delayed memory) were evaluated using the Montreal Cognitive Assessment.

RESULTS

Backward-stepwise linear regression indicated that the Visuospatial/Executive subtest was related to motor skill transfer (i.e., the amount of change in performance on the untrained motor task), such that participants with higher visuospatial scores improved more on the untrained dexterity task than those with lower scores. Global cognitive status was unrelated to motor skill transfer.

DISCUSSION

Consistent with previous studies showing a positive relationship between visuospatial function and other aspects of motor learning, this secondary analysis indicates that less motor skill transfer among older adults may indeed be due to declines in visuospatial function.

CONCLUSIONS

The present study highlights the potential utility of assessing older patients' visuospatial ability within motor rehabilitation to provide valuable insight into the extent to which they may learn and generalize motor skills through training.

Gamified Motor Training With Tangible Robots in Older Adults: A Feasibility Study and Comparison With the Young

Background: An increasing lifespan and the resulting change in our expectations of later life stages are dependent on a good health state. This emphasizes the importance of the development of strategies to further strengthen healthy aging. One important aspect of good health in later life stages is sustained skilled motor function.

Objective: Here, we tested the effectiveness of robotic upper limb motor training in a game-like scenario assessing game-based learning and its transfer potential.

Methods: Thirty-six healthy participants (n = 18 elderly participants, n = 18 young controls) trained with a Pacman-like game using a hand-held Cellulo robot on 2 consecutive days. The game-related movements were conducted on a printed map displaying a maze and targets that had to be collected. Gradually, the task difficulty was adjusted between games by modifying or adding different game elements (e.g., speed and number of chasing ghosts, additional rules, and haptic feedback). Transfer was assessed by scoring simple robot manipulation on two different trajectories.

Results: Elderly participants were able to improve their game performance over time [t₍₈₇₄₎ = 2.97, p < 0.01]. The applied game elements had similar effects on both age groups. Importantly, the game-based learning was transferable to simple robot manipulation that resembles activities of daily life. Only minor age-related differences were present (smaller overall learning gain and different effects of the wall-crash penalty rule in the elderly group).

Conclusions: Gamified motor training with the Cellulo system has the potential to translate into an efficient and relatively low-cost robotic motor training tool for promoting upper limb function to promote healthy aging.

A Delayed Advantage: Multi-Session Training at Evening Hours Leads to Better Long-Term Retention of Motor Skill in the Elderly

The acquisition and retention of motor skills is necessary for everyday functioning in the elderly and may be critical in the context of motor rehabilitation. Recent studies indicate that motor training closely followed by sleep may result in better engagement of procedural (“how to”) memory consolidation processes in the elderly. Nevertheless, elderly individuals are mostly morning oriented and a common practice is to time rehabilitation programs to morning hours. Here, we tested whether the time-of-day wherein training is afforded (morning, 8–10:30 a.m., or evening, 6–9 p.m.) affects the long-term outcome of a multi-session motor practice program (10 sessions across 3–4 weeks) in healthy elderly participants. Twenty-nine (15 women) older adults (60–75 years) practiced an explicitly instructed five-element key-press sequence by repeatedly generating the sequence “as fast and accurately as possible.” The groups did not differ in terms of sleep habits and quality (1-week long actigraphy); all were morning-oriented individuals. All participants gained robustly from the intervention, shortening sequence tapping duration and retaining the gains (> 90%) at 1-month post-intervention, irrespective of the time-of-day of training. However, retesting at 7-months post-intervention showed that the attrition of the training induced gains was more pronounced in the morning trained group compared to the evening group (76 and 56.5% loss in sequence tapping time; 7/14 and 3/14 participants showed a > 5% decline in accuracy relative to end of training, respectively). Altogether, the results show that morning-oriented older adults effectively acquired skill in the performance of a sequence of finger movements, in both morning and evening practice sessions. However, evening training leads to a significant advantage, over morning training, in the long-term retention of the skill. Evening training should be considered an appropriate time window for motor skill learning in older adults, even in individuals with morning chronotype. The results are in line with the notion that motor training preceding a sleep interval may be better consolidated into long-term memory in the elderly, and thus result in lower forgetting rates.

Investigation of Feedback Schedules on Speech Motor Learning in Older Adults

BACKGROUND

The principles of motor learning (PML) emerged from studies of limb motor skills in healthy, young adults. The applicability of these principles to speech motor learning, and to older adults, is uncertain.

AIMS

The purpose of this study was to examine one PML, feedback frequency, and its effect on retention and generalization of a novel speech and comparable tracing task.

METHODS

Sixty older adults completed a speech motor learning task requiring the production of a novel phrase at speaking rates 2 times and 3 times slower than habitual rate. Participants also completed a limb motor learning task requiring the tracing of a sine wave 2x and 3x slower than habitual rate. Participants were randomly assigned to receive feedback every trial, every 5th trial, or every 10th trial. Mean absolute error was measured to examine immediate generalization, delayed generalization, and 2-day retention.

FINDINGS

Results suggested that feedback frequency did not have an effect on the retention and generalization of the speech or manual task, supporting the small but growing literature highlighting the constraints of generalizing the PML to other modalities and populations.

Functional Connectivity During Handgrip Motor Fatigue in Older Adults Is Obesity and Sex-Specific

The prevalence of obesity in older adults, particularly in females, is increasing rapidly and is associated with declines in both the brain and physical health. Both the obese and the female populations have shown greater motor fatigue than their counterparts, however, the central neural mechanisms for fatigue are unclear. The present study measured fatigue-related functional connectivity across frontal and sensorimotor areas using functional near-infrared spectroscopy (fNIRS). Fifty-nine older adults (30 non-obese and 29 obese) performed submaximal handgrip motor fatigue until voluntary exhaustion. Functional connectivity and cerebral hemodynamics were compared across eight cortical areas during motor fatigue and across obesity and sex groups along with neuromuscular fatigue outcomes (i.e., endurance time, strength loss, and force steadiness). Both obesity- and sex-specific functional architecture and mean activation differences during motor fatigue in older adults were observed, which were accompanied by fatigue-related changes in variability of force steadiness that differed between groups. While primary indicators of fatigue, i.e., endurance and strength loss, did not differ between groups, the motor steadiness changes indicated different neural adaptation strategies between the groups. These findings indicate that obesity and sex differences exist in brain function in older adults, which may affect performance during motor fatigue.

Comparison of motor skill learning, grip strength and memory recall on land and in chest-deep water

Immersion in chest-deep water may augment explicit memory in healthy adults however, there is limited information on how this environment might affect implicit memory or motor learning. The purpose of this study was to compare the speed and accuracy for learning a motor skill on land and in chest-deep water. Verbal word recall and grip strength were included to gain a more complete understanding of the intervention. Sixty-two younger adults (age = 23.3 ± 3.59 yrs.) were randomly assigned to either a water group immersed to the xiphoid or a land group. Participants in both groups completed the same eight practice trials of a mirror-drawing task on two separate days. Outcome measures for this task included time and error numbers to complete each drawing. The number of words recalled using a 12 word recall test, and peak grip strength using a hand dynamometer were measured each day of testing. The influence of environment and repeated practice on each outcome measure were assessed with an analysis of variance and effect sizes (ES). Time and errors for both groups significantly decreased with practice (p < 0.01, ES = 0.11-0.28), however the drawing time was greater in water than on land for trials 1, 5, and 6 (ES = 0.50-0.55). There was a 7% increase in words recalled (9.24 ± 1.19 vs 8.60 ± 1.19) and a 16% increase in grip strength (405 ± 104 vs 342 ± 83) for water than land groups (ES 0.54-0.64). Healthy adults in chest-deep water and on land display comparable mirror-drawing speed and accuracy after minimal practice. Curiously, water immersion may augment verbal word recall and grip strength abilities.

The effects of aging on cortico-spinal excitability and motor memory consolidation

We investigated whether cortico-spinal excitability (CSE), a marker of synaptic plasticity, is associated with age-related differences in the consolidation of motor memory. Young and older participants practiced a visuomotor tracking task. Skill retention was assessed 8 and 24 hours after motor practice. Transcranial magnetic stimulation applied over the primary motor cortex at rest and during an isometric muscle contraction was used to assess absolute and normalized to baseline CSE at different points after practice. When skill performance was normalized to baseline level, both groups showed similar gains in acquisition, but the young group showed better retention 24 hours after practice. The young group also showed greater absolute CSE assessed during the isometric muscle contraction. Although young participants with greater absolute CSE showed better skill retention, it was the capacity to increase CSE after motor practice, and not absolute CSE, what was associated with skill retention in older participants. Older adults who have the capacity to increase CSE during motor memory consolidation show a better capacity to retain motor skills.

Non-physical approaches to counteract age-related functional deterioration: Applications for rehabilitation and neural mechanisms

Normal and pathological ageing are associated with several motor impairments that reduce quality of life and represent a general challenge for public healthcare systems. Consequently, over the past decades, many scientists and physiotherapists dedicated their research to the development and improvement of safe and costless methods to counteract the progressive decline of motor functions with age. The urgency of finding new and easy to implement methods is even more paramount in case of acute pathologies (e.g. stroke or hip surgery). The frailty of older population makes it difficult or even impossible to use traditional physical therapy at an early stage after the occurrence of a pathology. To that purpose, non-physical approaches such as cognitive training (e.g. memory, attention training) and mental techniques (e.g. motor imagery) have grown in popularity for the elderly. Such methods, involving individual and/or group exercises, have shown particular effects on increasing or maintaining cognitive functions, as well as physical performances. Improving the motor function (especially in older age) requires an improvement of motor execution, i.e. the pathway from the brain motor areas to the muscle but also higher cognitive control. The present work reviews different non-physical interventions that can be used as a complementary approach by asymptomatic or frail older adults, and the effects thereof on functional performance. The use of cognitive training or motor imagery protocols is recommended when physical practice is limited or not possible. Finally, insights into the underlying neurophysiological mechanisms are proposed.

Associations Between Fine Motor Performance in Activities of Daily Living and Cognitive Ability in a Nondemented Sample of Older Adults: Implications for Geriatric Physical Rehabilitation

OBJECTIVE

Fine motor ability (FMA) is essential in certain activities of daily living (ADL) and is considered mostly as a component of physical function. We hypothesize that cognitive ability explains significant variance in ADL-related FMA, above and beyond what is explained by physical ability (grip strength).

METHOD

Origins of Variance in the Old Old Study (OCTO)-Twin participants ( n = 218), aged 80+ (dementia, stroke, Parkinson's disease excluded) were assessed on depressive symptoms (Center for Epidemiologic Studies-Depression Scale [CES-D]), a cognitive battery, grip strength, and FMA.

RESULTS

In a series of ordinary least squares regression models, FMA was not associated with gender or depressive symptoms, but was associated with age (marginally; β = -.164, p = .051), grip strength (β = -.381, p < .01), and one cognitive measure, perceptual speed (β = -.249, p < .01).

DISCUSSION

In nondemented older adults, cognitive speed predicts ADL-related FMA after controlling for age and physical ability. Physical rehabilitation of FMA in ADL tasks should consider the importance of cognitive ability, even in nondemented older adults.

Vibrotactile feedback as a tool to improve motor learning and sports performance: a systematic review

BACKGROUND

Evidence concerning the use of vibrotactile feedback for acquiring and learning new motor skills is limited. Although various concepts and applications for tactile feedback have been proposed, little is known about the suitability of this feedback mechanism in sports training.

AIM

The goal of this systematic review was to gather knowledge on the efficacy of the use of vibrotactile feedback in improving sports performance skills.

DESIGN

Systematic review.

METHODS

Comprehensively searched databases were: PubMed, Cochrane and Web of Science. Studies investigating the effects of using vibrotactile feedback in sports training in healthy subjects were included in this review.

RESULTS

No consensus was found regarding the positive effectiveness on performance using vibrotactile feedback in a sports context. No evidence was found that the addition of tactile feedback is effective for acquiring new motor skills. None of the studies show a significant learning effect.

Relative cortico-subcortical shift in brain activity but preserved training-induced neural modulation in older adults during bimanual motor learning

To study age-related differences in neural activation during motor learning, functional magnetic resonance imaging scans were acquired from 25 young (mean 21.5-year old) and 18 older adults (mean 68.6-year old) while performing a bimanual coordination task before (pretest) and after (posttest) a 2-week training intervention on the task. We studied whether task-related brain activity and training-induced brain activation changes differed between age groups, particularly with respect to the hyperactivation typically observed in older adults. Findings revealed that older adults showed lower performance levels than younger adults but similar learning capability. At the cerebral level, the task-related hyperactivation in parietofrontal areas and underactivation in subcortical areas observed in older adults were not differentially modulated by the training intervention. However, brain activity related to task planning and execution decreased from pretest to posttest in temporo-parieto-frontal areas and subcortical areas in both age groups, suggesting similar processes of enhanced activation efficiency with advanced skill level. Furthermore, older adults who displayed higher activity in prefrontal regions at pretest demonstrated larger training-induced performance gains. In conclusion, in spite of prominent age-related brain activation differences during movement planning and execution, the mechanisms of learning-related reduction of brain activation appear to be similar in both groups. Importantly, cerebral activity during early learning can differentially predict the amplitude of the training-induced performance benefit between young and older adults.

Explicit Action Switching Interferes with the Context-Specificity of Motor Memories in Older Adults

Healthy aging impairs the ability to adapt movements to novel situations and to switch choices according to the context in cognitive tasks, indicating resistance to changes in motor and cognitive behaviors. Here we examined if this lack of “flexibility” in old subjects observed in motor and cognitive domains were related. To this end, we evaluated subjects' performance in a motor task that required switching walking patterns and its relation to performance in a cognitive switching task. Specifically, a group of old (>73 years old) and young subjects learned a new locomotor pattern on a split-belt treadmill, which drives the legs at different speeds. In both groups, we assessed the ability to disengage the walking pattern learned on the treadmill when walking overground. Then, we determined if this motor context-specificity was related to subjects' cognitive ability to switch actions in a set-shift task. Motor and cognitive behaviors were tested twice on separate visits to determine if age-related differences were maintained with exposure. Consistent with previous studies, we found that old adults adapted slower and had deficits in retention. Most importantly, we found that older subjects could not switch locomotor patterns when transitioning across walking contexts. Interestingly, cognitive switching performance was inversely related to subjects' ability to switch walking patterns. Thus, cognitive mediated switching interfered with locomotor switching. These findings were maintained across testing sessions. Our results suggest that distinct neural substrates mediate motor and cognitive action selection, and that these processes interfere with each other as we age.

Applying Aspects of the Expert Performance Approach to Better Understand the Structure of Skill and Mechanisms of Skill Acquisition in Video Games

Video games are ideal platforms for the study of skill acquisition for a variety of reasons. However, our understanding of the development of skill and the cognitive representations that support skilled performance can be limited by a focus on game scores. We present an alternative approach to the study of skill acquisition in video games based on the tools of the Expert Performance Approach. Our investigation was motivated by a detailed analysis of the behaviors responsible for the superior performance of one of the highest scoring players of the video game Space Fortress (Towne, Boot, & Ericsson, ). This analysis revealed how certain behaviors contributed to his exceptional performance. In this study, we recruited a participant for a similar training regimen, but we collected concurrent and retrospective verbal protocol data throughout training. Protocol analysis revealed insights into strategies, errors, mental representations, and shifting game priorities. We argue that these insights into the developing representations that guided skilled performance could only easily have been derived from the tools of the Expert Performance Approach. We propose that the described approach could be applied to understand performance and skill acquisition in many different video games (and other short- to medium-term skill acquisition paradigms) and help reveal mechanisms of transfer from gameplay to other measures of laboratory and real-world performance.

Regional cerebellar volumetric correlates of manual motor and cognitive function

Cerebellar volume declines with aging. Few studies have investigated age differences in regional cerebellar volume (RCV) and their association with motor and cognitive function. In 213 healthy older adults, we investigated the association of age with motor skills, cognition and RCV. Subsequently, we studied the association of RCV with motor skills and cognition. RCVs were derived from T1-weighted MRI scans using the automated SUIT segmentation method and clustered using principal component analysis (PCA). Motor skill (manual dexterity, tapping speed, bimanual visuomotor coordination, grip force) and cognition (mental rotation, verbal memory, inhibition, mental flexibility) were assessed. Behavioral measures were clustered into compounds using PCA: left hand motor skill, right hand motor skill, verbal memory and mental flexibility, and mental rotation & inhibition. Volume of the rostral middle frontal gyri (rMFG) and premotor areas (PMA) were related to performance for reference. Analyses were adjusted for age, sex, and education. Volume of the cerebellar anterior lobe and top of the superior posterior lobe were positively associated with motor skill. Volume of the bottom part of the posterior superior lobe and the inferior posterior lobe was positively associated with cognition. PMA volume was associated with cognition and motor skill and rMFG volume with motor skill. Although these results did not survive FDR correction, their effect sizes suggest that regional cerebellar volume selectively contributes to cognitive and motor skill. Effect sizes of cerebellar associations with performance were similar to those of rMFG/PMA and performance suggesting parallel contributions to performance.

A virtual water maze revisited: Two-year changes in navigation performance and their neural correlates in healthy adults

Age-related declines in spatial navigation are associated with deficits in procedural and episodic memory and deterioration of their neural substrates. For the lack of longitudinal evidence, the pace and magnitude of these declines and their neural mediators remain unclear. Here we examined virtual navigation in healthy adults (N=213, age 18-77 years) tested twice, two years apart, with complementary indices of navigation performance (path length and complexity) measured over six learning trials at each occasion. Slopes of skill acquisition curves and longitudinal change therein were estimated in structural equation modeling, together with change in regional brain volumes and iron content (R2* relaxometry). Although performance on the first trial did not differ between occasions separated by two years, the slope of path length improvement over trials was shallower and end-of-session performance worse at follow-up. Advanced age, higher pulse pressure, smaller cerebellar and caudate volumes, and greater caudate iron content were associated with longer search paths, i.e. poorer navigation performance. In contrast, path complexity diminished faster over trials at follow-up, albeit less so in older adults. Improvement in path complexity after two years was predicted by lower baseline hippocampal iron content and larger parahippocampal volume. Thus, navigation path length behaves as an index of perceptual-motor skill that is vulnerable to age-related decline, whereas path complexity may reflect cognitive mapping in episodic memory that improves with repeated testing, although not enough to overcome age-related deficits.

Proactive and retroactive transfer of middle age adults in a sequential motor learning task

We assessed the effects of aging in the transfer of motor learning in a sequential manual assembly task that is representative for real working conditions. On two different days, young (18-30 years) and middle-aged adults (50-65 years) practiced to build two products that consisted of the same six components but which had to be assembled in a partly different order. Assembly accuracy and movement time during tests, which were performed before and after the practice sessions, were compared to determine proactive and retroactive transfer. The results showed proactive facilitation (i.e., benefits from having learned the first product on learning the second one) in terms of an overall shortening of movement time in both age-groups. In addition, only the middle-aged adults were found to show sequence-specific proactive facilitation, in which the shortening of movement time was limited to components that had the same the order in the two products. Most likely, however, the sequence-specific transfer was an epiphenomenon of the comparatively low rate of learning among the middle-aged adults. The results, however, did reveal genuine differences between the groups for retroactive transfer (i.e., effects from learning the second product on performance of the first). Middle-aged adults tended to show more pronounced retroactive interference in terms of a general decrease in accuracy, while younger adults showed sequence-specific retroactive facilitation (i.e., shortening of movement times for components that had the same order in the two products), but only when they were fully accurate. Together this suggests that in the learning of sequential motor tasks the effects of age are more marked for retroactive transfer than for proactive transfer.

Age and practice effects on inter-manual performance asymmetry

Manual dexterity declines with increasing age, however, the way in which inter-manual asymmetry responds to aging is unclear. Our purpose was to determine the effect of age and practice on inter-manual performance asymmetry in an isometric force pinch line tracing task that varied in difficulty within segments. Thirty right-handed participants, five males and five females in each of three age groups, young (Y20), young–old (O70), and old–old (O80), practiced an isometric force pinch task for 10 trials with each hand on each of five consecutive days. Inter-manual performance asymmetry of the right and left hands was analyzed with a repeated measures analysis of variance (ANOVA) of asymmetry with age groups, practice, task difficulty, and hand as factors. The within-individual magnitude of asymmetry was also analyzed with a repeated measures ANOVA of manual asymmetry calculated as an asymmetry index (AI). Post hoc pair-wise comparisons were performed when significance was found. We observed no inter-manual performance asymmetry on this isometric tracing task among any of the age groups, either in the hand performance differences or in the magnitude of the AI. Age and practice interacted in terms of manual performance: the Y20 and O70 group improved accuracy and task time across the 5 days of practice but the O80 group did not. However, practice did not differentially affect the AI for accuracy or task time for any group. Accuracy of performance of the two hands was differentially affected by practice. All age groups exhibited poorer performance and larger AIs on the most difficult segments of the task (3 and 6) and this did not change with practice.

Fast but fleeting: adaptive motor learning processes associated with aging and cognitive decline

Motor learning has been shown to depend on multiple interacting learning processes. For example, learning to adapt when moving grasped objects with novel dynamics involves a fast process that adapts and decays quickly-and that has been linked to explicit memory-and a slower process that adapts and decays more gradually. Each process is characterized by a learning rate that controls how strongly motor memory is updated based on experienced errors and a retention factor determining the movement-to-movement decay in motor memory. Here we examined whether fast and slow motor learning processes involved in learning novel dynamics differ between younger and older adults. In addition, we investigated how age-related decline in explicit memory performance influences learning and retention parameters. Although the groups adapted equally well, they did so with markedly different underlying processes. Whereas the groups had similar fast processes, they had different slow processes. Specifically, the older adults exhibited decreased retention in their slow process compared with younger adults. Within the older group, who exhibited considerable variation in explicit memory performance, we found that poor explicit memory was associated with reduced retention in the fast process, as well as the slow process. These findings suggest that explicit memory resources are a determining factor in impairments in the both the fast and slow processes for motor learning but that aging effects on the slow process are independent of explicit memory declines.

Balance control interferes with the tracing performance of a pattern with mirror-reversed vision in older persons

When tracing a template with mirror-reversed vision (or distorted vision), the sensory information arising from the movement does not match the expected sensory consequences. In such situations, participants have to learn a new visuomotor mapping in order to trace the template with an accuracy and speed approaching that observed when tracing with direct vision. There are several suggestions that such visuomotor learning requires lowering the gain of the proprioceptive inputs. Generally, subjects learn this task in a seated condition offering a stable postural platform. Adapting to the new visuomotor relationship in a standing condition could add complexity and even hinder sensorimotor adaptation because balance control and processing of additional information typically interfere with each other. To examine this possibility, older individuals and young adults (on average, 70 and 22 years of age, respectively) were assigned to groups that trained to trace a shape with mirror-reversed vision in a seated or a standing condition for two sessions. For a third session, the seated groups (young and elderly) transferred to the standing condition while the standing groups continued to perform the tracing task while standing. This procedure allowed comparing the tracing performance of all groups (with the same amount of practice) in a standing condition. The standing groups also did a fourth session in a seated condition. Results show that older participants initially exposed to the standing condition were much slower to trace the template than all other groups (including the older group that performed the tracing task while seated). This slowness did not result from a baseline general slowness but from a genuine interference between balance control and the visuomotor conflict resulting from tracing the pattern with mirror-reversed vision. Besides, the Standing-Old participants that transferred to a seated condition in the fourth session immediately improved their tracing by reducing the total displacement covered by the pen to trace the template. Interestingly, the results did not support a transfer-appropriate practice hypothesis which suggests that training in a standing condition (at the third session) should have benefited the performance of those individuals who initially learned to trace the mirror pattern in a standing condition. This has important clinical implications: training at adapting to new sensory contexts or environmental conditions in conditions that do not challenge balance control could be necessary if one desires to attenuate the detrimental consequences on the postural or motor performances brought up by the interference between maintaining balance and the sensory reweighing processes.

Age differences in speech motor performance on a novel speech task

PURPOSE

The study was aimed at characterizing age-related changes in speech motor performance on a nonword repetition task as a function of practice and nonword length and complexity.

METHOD

Nonword repetition accuracy, lip aperture coordination, and nonword production durations were assessed on 2 consecutive days for 16 young and 16 elderly participants for the production of 6 novel nonwords increasing in length and complexity.

RESULTS

The effect of age on the ability to accurately and rapidly repeat long, complex nonwords was significant. However, the authors found no differences between the speech motor coordinative patterns of young and elderly adults. Further, the authors demonstrated age- and nonword-specific within- and between-session gains in speech motor performance.

CONCLUSIONS

The authors speculate that cognitive, sensory, and motor factors interact in complex ways in elderly individuals to produce individual differences in nonword repetition ability at the levels of both behavioral and speech motor performance.

Sensorimotor Adaptation Training’s Effect on Head Stabilization in Response to a Lateral Perturbation in Older Adults

The goal of this study was to determine if exposure to sensorimotor adaptation training improved head stabilization in older adults. Sixteen participants, age 66–81 yr, were assigned at random to the control group (n= 8) or the experimental group (n= 8). Both groups first completed 6 trials of walking a foam pathway consisting of a moveable platform that induced a lateral perturbation during walking. Head-in-space and trunk-in-space angular velocities were collected. Participants from both groups then trained twice per week for 4 wk. Both groups walked on a treadmill for 20 min. The control group viewed a static scene. The experimental group viewed a rotating visual scene that provided a perceptual-motor mismatch. After training, both groups were retested on the perturbation pathway test. The experimental group used a movement strategy that preserved head stabilization compared with the controls (p< .05). This training effect was not retained after 4 wk.

Neural correlates of the age-related changes in motor sequence learning and motor adaptation in older adults

As the world's population ages, a deeper understanding of the relationship between aging and motor learning will become increasingly relevant in basic research and applied settings. In this context, this review aims to address the effects of age on motor sequence learning (MSL) and motor adaptation (MA) with respect to behavioral, neurological, and neuroimaging findings. Previous behavioral research investigating the influence of aging on motor learning has consistently reported the following results. First, the initial acquisition of motor sequences is not altered, except under conditions of increased task complexity. Second, older adults demonstrate deficits in motor sequence memory consolidation. And, third, although older adults demonstrate deficits during the exposure phase of MA paradigms, the aftereffects following removal of the sensorimotor perturbation are similar to young adults, suggesting that the adaptive ability of older adults is relatively intact. This paper will review the potential neural underpinnings of these behavioral results, with a particular emphasis on the influence of age-related dysfunctions in the cortico-striatal system on motor learning.

Characterizing cognitive aging of spatial and contextual memory in animal models

Episodic memory, especially memory for contextual or spatial information, is particularly vulnerable to age-related decline in humans and animal models of aging. The continuing improvement of virtual environment technology for testing humans signifies that widely used procedures employed in the animal literature for examining spatial memory could be developed for examining age-related cognitive decline in humans. The current review examines cross species considerations for implementing these tasks and translating findings across different levels of analysis. The specificity of brain systems as well as gaps in linking human and animal laboratory models is discussed.

Neuropsychology and cognitive health in healthy older adults: a brief overview for psychiatric nurses

This article contains a brief synopsis on nonpathological aspects of the neuropsychology of aging and cognitive health. In nonpathological aging, normal subtle decline occurs in a number of cognitive domains such as executive functioning, speed of processing, memory, language, and psychomotor ability; however, some domains of cognitive functioning appear to increase with age, such as vocabulary and crystallized intelligence. In the neuropsychology and the cognitive aging literatures, several hypotheses for such age-related declines are proposed, including the diminished speed-of-processing hypothesis, the common cause hypothesis, and the frontal aging hypothesis. As these age-related changes diminish cognitive reserve, the decline in the related cognitive domains emerges. Ways to protect and improve cognitive health are suggested to encourage positive neuroplasticity and discourage negative neuroplasticity. Implications for nursing practice are provided.

Learning to resist gait-slip falls: long-term retention in community-dwelling older adults

OBJECTIVES

To determine whether the fall-resisting skills acquired from a single perturbation training session can be retained for 6 months or enhanced by an intermediate ancillary session.

DESIGN

A randomized controlled trial.

SETTING

Biomechanics research laboratory.

PARTICIPANTS

Community-dwelling elderly (N=48; age, >65 y).

INTERVENTIONS

Initial perturbation training applied to all subjects using low-friction platforms to induce unannounced blocks of repeated right-side slips, interspersed with nonslips. The single-session group retested with only 1 slip 6 months later. The dual-session group received an additional slip at 3 months after the initial session, followed by a retest of slips at 6 months.

MAIN OUTCOME MEASURES

Slip outcome (incidence of falls and balance loss), dynamic stability (based on the center-of-mass position and velocity), and vertical limb support (based on hip height).

RESULTS

Subjects in both groups significantly reduced fall and balance loss incidence from first to last training slips, which resulted from improved stability and limb support control. Both groups demonstrated significant retention in all outcome measures at 6 months compared with the first novel slip, although performance decay was evident in comparison with the last training slip. The ancillary slip at 3 months led to significantly better control of stability and, hence, reduced balance loss outcome, in the dual-session group at 6 months than in the single-session group.

CONCLUSIONS

Motor memory could be retained for 6 months or longer after a single session of fall-resistance training, although a single "booster" slip could further impede its decay. Through the experience of slipping and falling, it may be possible to "inoculate" older adults against potentially life-threatening falls.

Parallel declines in cognition, motivation, and locomotion in aging mice: association with immune gene upregulation in the medial prefrontal cortex

Aging in humans is associated with parallel changes in cognition, motivation, and motoric performance. Based on the human aging literature, we hypothesized that this constellation of age-related changes is mediated by the medial prefrontal cortex and that it would be observed in aging mice. Toward this end, we performed detailed assessments of cognition, motivation, and motoric behavior in aging mice. We assessed behavioral and cognitive performance in C57Bl/6 mice aged 6, 18, and 24 months, and followed this with microarray analysis of tissue from the medial prefrontal cortex and analysis of serum cytokine levels. Multivariate modeling of these data suggested that the age-related changes in cognition, motivation, motor performance, and prefrontal immune gene expression were highly correlated. Peripheral cytokine levels were also correlated with these variables, but less strongly than measures of prefrontal immune gene upregulation. To determine whether the observed immune gene expression changes were due to prefrontal microglial cells, we isolated CD11b-positive cells from the prefrontal cortex and subject them to next-generation RNA sequencing. Many of the immune changes present in whole medial prefrontal cortex were enriched in this cell population. These data suggest that, as in humans, cognition, motivation, and motoric performance in the mouse change together with age and are strongly associated with CNS immune gene upregulation.

Categorical scaling of duration as a function of temporal context in aged rats

Aged male rats at 10, 20, and 30 mo of age were trained on a 2.0 vs. 8.0-s duration bisection procedure using both auditory and visual signals and were then tested with visual signal durations in which the spacing of the intermediate signal durations was held constant as the short (S) and long (L) anchor durations were moved progressively closer to each other across blocks of sessions. Auditory clicks also preceded some trials in order to determine the potential effects of arousal and/or distraction on the timing of visual signals. The consequences of aging, reducing the S:L ratio, and auditory clicks were to increase the likelihood of observing reversals in response classifications around the geometric mean of the anchor durations. Taken together, these results suggest that the bisection "reversal effect" is dependent upon the calculation of the subjective mid-point between the two anchor durations and the differential setting of response thresholds around this category boundary as a function of temporal context.

Failure to engage spatial working memory contributes to age-related declines in visuomotor learning

It is well documented that both cognitive and motor learning abilities decline with normative aging. Given that cognitive processes such as working memory are engaged during the early stages of motor learning [Anguera, J., Reuter-Lorenz, P., Willingham, D., & Seidler, R. Contributions of spatial working memory to visuomotor learning. Journal of Cognitive Neuroscience, 22(9), 1917-1930, 2010], age-related declines in motor learning may be due in part to reductions in cognitive ability. The present study examined whether age-related declines in spatial working memory (SWM) contribute to deficits in visuomotor adaptation. Young and older adult participants performed a visuomotor adaptation task that involved adapting manual aiming movements to a 30° rotation of the visual feedback display as well as an SWM task in an fMRI scanner. Young adults showed a steeper learning curve than older adults during the early adaptation period. The rate of early adaptation was correlated with SWM performance for the young, but not older, adults. Both groups showed similar brain activation patterns for the SWM task, including engagement of the right dorsolateral prefrontal cortex and bilateral inferior parietal lobules. However, when the SWM activation was used as a limiting mask, younger adults showed neural activation that overlapped with the early adaptation period, whereas older adults did not. A partial correlation controlling for age revealed that the rate of early adaptation correlated with the amount of activation at the right dorsolateral prefrontal cortex. These findings suggest that a failure to effectively engage SWM processes during learning contributes to age-related deficits in visuomotor adaptation.

One-year retention of general and sequence-specific skills in a probabilistic, serial reaction time task

Procedural skills such as riding a bicycle and playing a musical instrument play a central role in daily life. Such skills are learned gradually and are retained throughout life. The present study investigated 1-year retention of procedural skill in a version of the widely used serial reaction time task (SRTT) in young and older motor-skill experts and older controls in two experiments. The young experts were college-age piano and action video-game players, and the older experts were piano players. Previous studies have reported sequence-specific skill retention in the SRTT as long as 2 weeks but not at 1 year. Results indicated that both young and older experts and older non-experts revealed sequence-specific skill retention after 1 year with some evidence that general motor skill was retained as well. These findings are consistent with theoretical accounts of procedural skill learning such as the procedural reinstatement theory as well as with previous studies of retention of other motor skills.

Age-related changes in processing speed: unique contributions of cerebellar and prefrontal cortex

Age-related declines in processing speed are hypothesized to underlie the widespread changes in cognition experienced by older adults. We used a structural covariance approach to identify putative neural networks that underlie age-related structural changes associated with processing speed for 42 adults ranging in age from 19 to 79 years. To characterize a potential mechanism by which age-related gray matter changes lead to slower processing speed, we examined the extent to which cerebral small vessel disease influenced the association between age-related gray matter changes and processing speed. A frontal pattern of gray matter and white matter variation that was related to cerebral small vessel disease, as well as a cerebellar pattern of gray matter and white matter variation were uniquely related to age-related declines in processing speed. These results demonstrate that at least two distinct factors affect age-related changes in processing speed, which might be slowed by mitigating cerebral small vessel disease and factors affecting declines in cerebellar morphology.

Aging, training, and the brain: a review and future directions

As the population ages, the need for effective methods to maintain or even improve older adults' cognitive performance becomes increasingly pressing. Here we provide a brief review of the major intervention approaches that have been the focus of past research with healthy older adults (strategy training, multi-modal interventions, cardiovascular exercise, and process-based training), and new approaches that incorporate neuroimaging. As outcome measures, neuroimaging data on intervention-related changes in volume, structural integrity; and functional activation can provide important insights into the nature and duration of an intervention's effects. Perhaps even more intriguingly, several recent studies have used neuroimaging data as a guide to identify core cognitive processes that can be trained in one task with effective transfer to other tasks that share the same underlying processes. Although many open questions remain, this research has greatly increased our understanding of how to promote successful aging of cognition and the brain.

Neuroanatomical and cognitive mediators of age-related differences in perceptual priming and learning

Our objectives were to assess age differences in perceptual repetition priming and perceptual skill learning and to determine whether they are mediated by cognitive resources and regional cerebral volume differences. Fragmented picture identification paradigm allows the study of both priming and learning within the same task. The authors presented this task to 169 adults (ages 18-80), assessed working memory and fluid intelligence, and measured brain volumes of regions that were deemed relevant to those cognitive skills. The data were analyzed within a hierarchical path modeling framework. In addition to finding age-related decrease in both perceptual priming and learning, the authors observed several dissociations with regards to their neural and cognitive mediators. Larger visual cortex volume was associated with greater repetition priming, but not perceptual skill learning, and neither process depended upon hippocampal volume. In contrast, the volumes of the prefrontal gray and white matter were differentially related to both processes via direct and indirect effects of cognitive resources. The results indicate that age-related differences in perceptual priming and skill learning have dissociable cognitive and neural correlates.

Prevention of slip-related backward balance loss: the effect of session intensity and frequency on long-term retention

OBJECTIVE

To examine the effects of session intensity (number of slip exposures) and frequency on the retention of acquired adaptation for prevention of backward balance loss after repeated-slip training.

DESIGN

A 4-group, randomized, and controlled study.

SETTING

Biomechanics research laboratory.

PARTICIPANTS

Healthy young subjects (N=46; 21 men).

INTERVENTIONS

Twenty-four subjects experienced a high-intensity session of 24 repeated right-side slips; 12 received additional single-slip sessions at a frequency of 1 week, 2 weeks, and 1 month, whereas the rest got no ancillary training. Another 24 subjects received a low-intensity initial session of a single slip; 12 received the same high-frequency ancillary training, whereas the rest got none. All groups were retested with a single slip 4 months after the first session.

MAIN OUTCOME MEASURES

The incidence of backward balance loss, gait stability, and limb support.

RESULTS

The high-intensity groups, irrespective of ancillary training, displayed similar improvements in all 3 outcome measures. Remarkably, the low-intensity group receiving ancillary training also significantly improved in all measures, with retention comparable to that observed in the other 2 groups. A single-slip exposure without ancillary sessions was insufficient to yield a longer-term effect.

CONCLUSIONS

Frequent ancillary sessions may be unnecessary for slip-related fall prevention up to 4 months if the initial session intensity is sufficient. Furthermore, the minimum of a single slip may be as effective if the subject is exposed to frequent ancillary sessions.