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Vance DE, Fazeli PL, Azuero A, Frank JS, Wadley VG, Raper JL, Pope CN, Ball KK. A 2-Year Longitudinal Randomized Control Trial of Speed of Processing Cognitive Training in Aging Adults with HIV-Associated Neurocognitive Disorder: Results of the Think Fast Study. AIDS Behav 2024:10.1007/s10461-024-04409-9. [PMID: 38954173 DOI: 10.1007/s10461-024-04409-9] [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] [Accepted: 06/03/2024] [Indexed: 07/04/2024]
Abstract
Nearly 40% of people with HIV (PWH) experience HIV-associated Neurocognitive Disorder (HAND). In this 3-group efficacy study, 216 PWH 40 + years with HAND or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73), or (3) 10 h of Internet navigation training (n = 73; contact control group). Participants were administered a measure of SOP [i.e., the Useful Field of View Test (UFOV®)] at baseline, at posttest immediately after training, and at year 1 and year 2 follow up. Intent-to-treat linear mixed-effect models with subject-specific intercept and slope were fitted to estimate between-group mean differences at the follow-up time-points. At the post-intervention time-point, small beneficial SOP training effects were observed for the 10-h group in UFOV® total (d = 0.28, p = 0.002). Effects were of larger magnitude for the 20-h group in these same outcomes [UFOV® total (d = 0.43, p < 0.001)]. These results indicated better benefit with more training. No intervention effect was observed at year 1. At year 2, beneficial effects of small magnitude were observed again in the 10-h group [UFOV® total (d = 0.22, p = 0.253)] with larger small-to-moderate magnitude in the 20-h group [UFOV® total (d = 0.32, p = 0.104)]. This study suggests that SOP training can improve a key indicator of this cognitive performance and that treatment gains are small-to-moderate over a two-year period. Prior literature suggests slower SOP is predictive of impairment in everyday functioning in older PWH; such an approach could potentially improve everyday functioning in PWH.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, 35294-1210, USA.
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, 35294-1210, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, 35294-1210, USA
| | - Jennifer S Frank
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, 35294-1210, USA
| | - Virginia G Wadley
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James L Raper
- The 1917 (HIV/AIDS) Clinic, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Caitlin N Pope
- Department of Health, Behavior & Society, University of Kentucky, Lexington, KY, USA
| | - Karlene K Ball
- Department of Psychology, UAB, University of Alabama at Birmingham, Birmingham, AL, USA
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2
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Wyche NJ, Edwards M, Goodhew SC. Different deployments of attentional breadth selectively predict UFOV task performance in older adults. Cogn Res Princ Implic 2024; 9:42. [PMID: 38922541 PMCID: PMC11208374 DOI: 10.1186/s41235-024-00569-3] [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: 02/19/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
The Useful Field of View task (UFOV) is a strong and reliable predictor of crash risk in older drivers. However, while the functional domain of attention is clearly implicated in UFOV performance, the potential role of one specific attentional process remains unclear: attentional breadth (the spatial extent of the attended region around the point of visual fixation). The goal of the present study was to systematically test the role of two distinct aspects of attentional breadth, maintaining a specific breadth of attention and resizing the attended region, in UFOV performance. To this end, 135 older adults completed the UFOV and modified Navon tasks to measure their efficiency in maintaining, contracting, and expanding the breadth of attention. We then examined individual-difference associations between these aspects of attentional breadth deployment and UFOV performance. We found that performance on UFOV Subtask 2 was associated with efficient contraction of attentional breadth (i.e., resizing the attended region to a smaller area), while Subtask 3 performance was associated with the efficiency of expanding attentional breadth (i.e., resizing the attended region to a larger area). The selectivity of these relationships appears to implicate these specific deployments of attentional breadth in how people complete the task, as it suggests that these relationships are not simply attributable to shared variance in a broader domain of cognitive functioning. The implications of these results for our understanding of UFOV, as well as future research directions that test the relative contributions of different cognitive processes in predicting task performance, are discussed.
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Affiliation(s)
- Nicholas J Wyche
- School of Medicine and Psychology (Building 39), Australian National University, Canberra, ACT, 2601, Australia.
| | - Mark Edwards
- School of Medicine and Psychology (Building 39), Australian National University, Canberra, ACT, 2601, Australia
| | - Stephanie C Goodhew
- School of Medicine and Psychology (Building 39), Australian National University, Canberra, ACT, 2601, Australia
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3
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Tapia JL, Duñabeitia JA. Driving safety: Investigating the cognitive foundations of accident prevention. Heliyon 2023; 9:e21355. [PMID: 38027813 PMCID: PMC10643293 DOI: 10.1016/j.heliyon.2023.e21355] [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: 06/14/2023] [Revised: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Driving is a crucial aspect of personal independence, and accurate assessment of driving skills is vital for ensuring road safety. This study aimed to identify reliable cognitive predictors of safe driving through a driving simulator experiment. We assessed the driving performance of 66 university students in two distinct simulated driving conditions and evaluated their cognitive skills in decision-making, attention, memory, reasoning, perception, and coordination. Multiple regression analyses were conducted to determine the most reliable cognitive predictor of driving outcome. Results revealed that under favorable driving conditions characterized by good weather and limited interactions with other road users, none of the variables tested in the study were able to predict driving performance. However, in a more challenging scenario with adverse weather conditions and heavier traffic, cognitive assessment scores demonstrated significant predictive power for the rate of traffic infractions committed. Specifically, cognitive skills related to memory and coordination were found to be most predictive. This study underscores the significance of cognitive ability, particularly memory, in ensuring safe driving performance. Incorporating cognitive evaluations in driver licensing and education/training programs can enhance the evaluation of drivers' competence and promote safer driving practices.
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Affiliation(s)
- Jose L. Tapia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, Madrid, Spain
| | - Jon Andoni Duñabeitia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, Madrid, Spain
- AcqVA Aurora Center, The Arctic University of Norway, Tromsø, Norway
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Michaels J, Chaumillon R, Mejia-Romero S, Bernardin D, Faubert J. Can Three-Dimensional Multiple Object Tracking Training Be Used to Improve Simulated Driving Performance? A Pilot Study in Young and Older Adults. JOURNAL OF COGNITIVE ENHANCEMENT 2023; 7:112-127. [PMID: 37351199 PMCID: PMC10123568 DOI: 10.1007/s41465-023-00260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/27/2023] [Indexed: 06/24/2023]
Abstract
Driving ability has been shown to be dependent on perceptual-cognitive abilities such as visual attention and speed of processing. There is mixed evidence suggesting that training these abilities may improve aspects of driving performance. This preliminary study investigated the feasibility of training three-dimensional multiple object tracking (3D-MOT)-a dynamic, speeded tracking task soliciting selective, sustained and divided attention as well as speed of processing-to improve measures of simulated driving performance in older and younger adults. A sample of 20 young adults (23-33 years old) and 14 older adults (65-76 years old) were randomly assigned to either a 3D-MOT training group or an active control group trained on a perceptual discrimination task as well as 2048. Participants were tested on a driving scenario with skill-testing events previously identified as optimal for cross-sectional comparisons of driving ability. Results replicated previously identified differences in driving behaviour between age groups. A possible trend was observed for the 3D-MOT trained group, especially younger adults, to increase the distance at which they applied their maximum amount of braking in response to dangerous events. This measure was associated with less extreme braking during events, implying that these drivers may have been making more controlled stops. Limitations of sample size and task realism notwithstanding, the present experiment offers preliminary evidence that 3D-MOT training might transfer to driving performance through quicker detection of or reaction to dangerous events and provides a rationale for replication with a larger sample size.
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Affiliation(s)
- Jesse Michaels
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Romain Chaumillon
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Sergio Mejia-Romero
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Delphine Bernardin
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
- Essilor International, Research and Development Department, Paris, France
- Essilor Canada, Saint-Laurent, Canada
| | - Jocelyn Faubert
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
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5
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Wood JM. Vision Impairment and On-Road Driving. Annu Rev Vis Sci 2022; 8:195-216. [DOI: 10.1146/annurev-vision-100820-085030] [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]
Abstract
Good vision is important for safe driving. The impact of vision impairment associated with common eye diseases on driving performance, and the association between vision measures and driving performance, are discussed. Studies include those where participants drove a real vehicle on a closed road or on public roads. Closed-road studies include evaluation of both simulated and true vision impairment and day- and night-time driving. Collectively, the findings provide important insights into the impact of refractive conditions, cataracts, glaucoma, age-related macular degeneration, and hemianopic field loss on driving; however, study results show varying impacts on driving performance and are often limited by small sample sizes. Vision measures including motion sensitivity, contrast sensitivity, and useful field of view have stronger associations with driving performance than do visual acuity or visual fields, with studies suggesting that some drivers with field loss can compensate for their field defects through increased eye and head movements.
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Affiliation(s)
- Joanne M. Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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6
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Sandness DJ, McCarter SJ, Dueffert LG, Shepard PW, Enke AM, Fields J, Mielke MM, Boeve BF, Silber MH, St. Louis EK. Cognition and driving ability in isolated and symptomatic REM sleep behavior disorder. Sleep 2022; 45:zsab253. [PMID: 34958375 PMCID: PMC8996024 DOI: 10.1093/sleep/zsab253] [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: 02/12/2021] [Revised: 04/28/2021] [Indexed: 12/30/2022] Open
Abstract
STUDY OBJECTIVES To analyze cognitive deficits leading to unsafe driving in patients with REM Sleep Behavior Disorder (RBD), strongly associated with cognitive impairment and synucleinopathy-related neurodegeneration. METHODS Twenty isolated RBD (iRBD), 10 symptomatic RBD (sRBD), and 20 age- and education-matched controls participated in a prospective case-control driving simulation study. Group mean differences were compared with correlations between cognitive and driving safety measures. RESULTS iRBD and sRBD patients were more cognitively impaired than controls in global neurocognitive functioning, processing speeds, visuospatial attention, and distractibility (p < .05). sRBD patients drove slower with more collisions than iRBD patients and controls (p < .05), required more warnings, and had greater difficulty following and matching speed of a lead car during simulated car-following tasks (p < .05). Driving safety measures were similar between iRBD patients and controls. Slower psychomotor speed correlated with more off-road accidents (r = 0.65) while processing speed (-0.88), executive function (-0.90), and visuospatial impairment (0.74) correlated with safety warnings in sRBD patients. Slower stimulus recognition was associated with more signal-light (0.64) and stop-sign (0.56) infractions in iRBD patients. CONCLUSIONS iRBD and sRBD patients have greater selective cognitive impairments than controls, particularly visuospatial abilities and processing speed. sRBD patients exhibited unsafe driving behaviors, associated with processing speed, visuospatial awareness, and attentional impairments. Our results suggest that iRBD patients have similar driving-simulator performance as healthy controls but that driving capabilities regress as RBD progresses to symptomatic RBD with overt signs of cognitive, autonomic, and motor impairment. Longitudinal studies with serial driving simulator evaluations and objective on-road driving performance are needed.
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Affiliation(s)
- David J Sandness
- Mayo Sleep Behavior and Neurophysiology Research Laboratory, Rochester, MN, USA
- Mayo Center for Sleep Medicine, Rochester, MN, USA
| | - Stuart J McCarter
- Mayo Sleep Behavior and Neurophysiology Research Laboratory, Rochester, MN, USA
- Mayo Center for Sleep Medicine, Rochester, MN, USA
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Lucas G Dueffert
- Mayo Sleep Behavior and Neurophysiology Research Laboratory, Rochester, MN, USA
- Park Nicollet Rehabilitation, Maple Grove, MN, USA
| | - Paul W Shepard
- Mayo Sleep Behavior and Neurophysiology Research Laboratory, Rochester, MN, USA
| | - Ashley M Enke
- Mayo Sleep Behavior and Neurophysiology Research Laboratory, Rochester, MN, USA
| | - Julie Fields
- Department of Psychiatry, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Bradley F Boeve
- Mayo Center for Sleep Medicine, Rochester, MN, USA
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Michael H Silber
- Mayo Center for Sleep Medicine, Rochester, MN, USA
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Erik K St. Louis
- Mayo Sleep Behavior and Neurophysiology Research Laboratory, Rochester, MN, USA
- Mayo Center for Sleep Medicine, Rochester, MN, USA
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
- Department of Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
- Mayo Clinic Health System Southwest Wisconsin, La Crosse, WI, USA
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7
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Laxton V, Mackenzie AK, Crundall D. An exploration into the contributing cognitive skills of lifeguard visual search. APPLIED COGNITIVE PSYCHOLOGY 2022. [DOI: 10.1002/acp.3913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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8
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Mason J, Tenenbaum G, Jaime S, Roque N, Maharaj A, Figueroa A. Arterial Stiffness and Cardiorespiratory Fitness Are Associated With Cognitive Function in Older Adults. Behav Med 2022; 48:54-65. [PMID: 33108259 PMCID: PMC8425270 DOI: 10.1080/08964289.2020.1825921] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Age-related cognitive impairment has been associated with arterial stiffening and decreased cardiorespiratory fitness. The aims of this cross-sectional study were to compare cognitive function domains and cardiovascular parameters in older adults (≥ 65 years old) with high and normal aortic stiffness (via carotid-femoral pulse wave velocity, cfPWV) and to explore relationships among cfPWV, carotid intima-media thickness, cardiorespiratory fitness, and cognitive function. Vascular and cognitive function were measured in older adults with either normal or high cfPWV. Cognitive function was measured via an intensive one-time neuropsychological battery, while cfPWV by applanation tonometry, carotid intima-media thickness and function (i.e., distensibility) by ultrasonography, and cardiorespiratory fitness (i.e., VO2peak) by a submaximal exercise test. Correlations among age, VO2peak, carotid intima-media thickness, cfPWV, and cognitive function were performed along with a series of multivariate analyses of variance. Compared with NAS, participants with HAS had greater aortic, carotid, and brachial blood pressures but similar cardiorespiratory fitness and carotid intima-media thickness and distensibility. Participants with NAS exhibited better neuropsychological performance in executive function and attention and overall cognitive function than those with HAS. When controlling for age, visual scanning and perception scores were correlated with cfPWV and VO2peak. Our findings suggest that certain cognitive domains for older adults are associated with their cardiorespiratory fitness and aortic stiffness.
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Affiliation(s)
- Justin Mason
- Department of Occupational Therapy, University of Florida, Gainesville, FL
| | - Gershon Tenenbaum
- Department of Social Psychology, Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Salvador Jaime
- Department of Exercise and Sport Science, University of Wisconsin – La Crosse, WI
| | - Nelson Roque
- Center for Healthy Aging, Pennsylvania State University, University Park, PA
| | - Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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9
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Classen S, Mason JR, Hwangbo SW, Sisiopiku V. Predicting Autonomous Shuttle Acceptance in Older Drivers Based on Technology Readiness/Use/Barriers, Life Space, Driving Habits, and Cognition. Front Neurol 2021; 12:798762. [PMID: 34925223 PMCID: PMC8674351 DOI: 10.3389/fneur.2021.798762] [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] [Received: 10/20/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Shared autonomous vehicle services (i. e., automated shuttles, AS) are being deployed globally and may improve older adults (>65 years old) mobility, independence, and participation in the community. However, AS must be user friendly and provide safety benefits if older drivers are to accept and adopt this technology. Current potential barriers to their acceptance of AS include a lack of trust in the systems and hesitation to adopt emerging technology. Technology readiness, perceived ease of use, perceived barriers, and intention to use the technology, are particularly important constructs to consider in older adults' acceptance and adoption practices of AS. Likewise, person factors, i.e., age, life space mobility, driving habits, and cognition predict driving safety among older drivers. However, we are not sure if and how these factors may also predict older adults' intention to use the AS. In the current study, we examined responses from 104 older drivers (M age = 74.3, SD age = 5.9) who completed the Automated Vehicle User Perception Survey (AVUPS) before and after riding in an on-road automated shuttle (EasyMile EZ10). The study participants also provided information through the Technology Readiness Index, Technology Acceptance Measure, Life Space Questionnaire, Driving Habits Questionnaire, Trail-making Test Part A and Part B (TMT A and TMT B). Older drivers' age, cognitive scores (i.e., TMT B), driving habits (i.e., crashes and/or citations, exposure, and difficulty of driving) and life space (i.e., how far older adults venture from their primary dwelling) were entered into four models to predict their acceptance of AVs-operationalized according to the subscales (i.e., intention to use, perceived barriers, and well-being) and the total acceptance score of the AVUPS. Next, a partial least squares structural equation model (PLS-SEM) elucidated the relationships between, technology readiness, perceived ease of use, barriers to AV acceptance, life space, crashes and/or citations, driving exposure, driving difficulty, cognition, and intention to use AS. The regression models indicated that neither age nor cognition (TMT B) significantly predicted older drivers' perceptions of AVs; but their self-reported driving difficulty (p = 0.019) predicted their intention to use AVs: R 2 = 6.18%, F (2,101) = 4.554, p = 0.040. Therefore, intention to use was the dependent variable in the subsequent PLS-SEM. Findings from the PLS-SEM (R 2 = 0.467) indicated the only statistically significant predictors of intention to use were technology readiness (β = 0.247, CI = 0.087-0.411) and barriers to AV acceptance (β = -0.504, CI = 0.285-0.692). These novel findings provide evidence suggesting that technology readiness and barriers must be better understood if older drivers are to accept and adopt AS.
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Affiliation(s)
- Sherrilene Classen
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Justin R Mason
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Seung Woo Hwangbo
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Virginia Sisiopiku
- Department of Civil, Construction, and Environmental Engineering, School of Engineering, University of Alabama at Birmingham, Birmingham, AL, United States
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10
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Shamsi F, Chen V, Liu R, Pergher V, Kwon M. Functional Field of View Determined by Crowding, Aging, or Glaucoma Under Divided Attention. Transl Vis Sci Technol 2021; 10:14. [PMID: 34910102 PMCID: PMC8684310 DOI: 10.1167/tvst.10.14.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose Parafoveal or peripheral vision is important for various everyday activities. This is particularly relevant to those who suffer from visual field defects. Here we quantified the effect of visual crowding, normal aging, and glaucoma on the spatial extent of the functional field of view (FFV) under divided attention. Methods Unlike visual acuity measured by single-letter recognition or visual perimetry measured by light spot detection, we measured the FFV using a target letter presented either alone or in letter triplets appearing across the visual field. A subject's task was to report whether the target letter was the same as the letter displayed concurrently at the central fixation region (i.e., divided attention task). Over the trials, a plot of the proportion correct for letter recognition versus target location was constructed, resulting in a visual field map. Results The results obtained from three subject groups—normal young adults, normal older adults, and patients with glaucoma—showed that on average the central 20° visual field was relatively robust to uncrowded target recognition under divided attention. However, the FFV shrunk down to the central 10° visual field when the target appeared in clutter, suggesting a strong crowding effect on FFV. An additional shrinkage of the FFV occurred in the presence of aging and glaucoma. Conclusions Using a quantitative method, we demonstrate that crowding, aging, and glaucoma independently decrease the spatial extent of FFV under divided attention and that crowding seems to be the major contributor limiting FFV. Translational Relevance Our FFV test may complement standard clinical measurements by providing functionally relevant visual field information.
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Affiliation(s)
- Foroogh Shamsi
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Victoria Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rong Liu
- Department of Psychology, Northeastern University, Boston, MA, USA.,Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Life Science and Medicine, University of Science and Technology of China, Hefei, China
| | | | - MiYoung Kwon
- Department of Psychology, Northeastern University, Boston, MA, USA.,Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Song J, Bennett PJ, Sekuler AB, Sun HJ. The effect of apparent distance on peripheral target detection. J Vis 2021; 21:8. [PMID: 34495294 PMCID: PMC8431976 DOI: 10.1167/jov.21.10.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Previous research suggests that peripheral target detection is modulated by viewing distance and distance simulated by pictorial cues and optic flow. In the latter case, it is unclear what cues contribute to the effect of distance. The current study evaluated the effect of distance on peripheral detection in a virtual three-dimensional environment. Experiments 1–3 used a continuous, dynamic central task that simulated observers traveling either actively or passively through a virtual environment following a car. Peripheral targets were flashed on checkerboard-covered walls to the left and right of the path of motion, at a near and a far distance from the observer. The retinal characteristics of the targets were identical across distances. Experiment 1 found more accurate and faster detection for near targets compared to far targets, especially for larger eccentricities. Experiment 2 equated the predictability of target onset across distances and found the near advantage for larger eccentricities in accuracy but a much smaller effect in reaction time (RT). Experiment 3 removed the checkerboard background implemented in Experiments 1 and 2, and Experiment 4 manipulated several static, monocular cues. Experiments 3 and 4 found that the variation in the density of the checkerboard backgrounds could explain the main effect of distance on accuracy but could not completely account for the interaction between target distance and eccentricity. These results suggest that attention is modulated by target distance, but the effect is small. Finally, there were consistent divided attention costs in the central car-following task but not the peripheral detection task.
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Affiliation(s)
- Jiali Song
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada.,
| | - Patrick J Bennett
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada.,
| | - Allison B Sekuler
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,
| | - Hong-Jin Sun
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada.,
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12
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Patoine A, Mikula L, Mejía-Romero S, Michaels J, Keruzoré O, Chaumillon R, Bernardin D, Faubert J. Increased visual and cognitive demands emphasize the importance of meeting visual needs at all distances while driving. PLoS One 2021; 16:e0247254. [PMID: 33724991 PMCID: PMC7963041 DOI: 10.1371/journal.pone.0247254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/04/2021] [Indexed: 11/19/2022] Open
Abstract
Having an optimal quality of vision as well as adequate cognitive capacities is known to be essential for driving safety. However, the interaction between vision and cognitive mechanisms while driving remains unclear. We hypothesized that, in a context of high cognitive load, reduced visual acuity would have a negative impact on driving behavior, even when the acuity corresponds to the legal threshold for obtaining a driving license in Canada, and that the impact observed on driving performance would be greater with the increase in the threshold of degradation of visual acuity. In order to investigate this relationship, we examined driving behavior in a driving simulator under optimal and reduced vision conditions through two scenarios involving different levels of cognitive demand. These were: 1. a simple rural driving scenario with some pre-programmed events and 2. a highway driving scenario accompanied by a concurrent task involving the use of a navigation device. Two groups of visual quality degradation (lower/ higher) were evaluated according to their driving behavior. The results support the hypothesis: A dual task effect was indeed observed provoking less stable driving behavior, but in addition to this, by statistically controlling the impact of cognitive load, the effect of visual load emerged in this dual task context. These results support the idea that visual quality degradation impacts driving behavior when combined with a high mental workload driving environment while specifying that this impact is not present in the context of low cognitive load driving condition.
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Affiliation(s)
- Amigale Patoine
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Laura Mikula
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Sergio Mejía-Romero
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Jesse Michaels
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Océane Keruzoré
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Romain Chaumillon
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Delphine Bernardin
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Essilor International Research and Development, Essilor Canada Ltd, Montréal, Québec, Canada
| | - Jocelyn Faubert
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
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Lodha N, Patel P, Shad JM, Casamento-Moran A, Christou EA. Cognitive and motor deficits contribute to longer braking time in stroke. J Neuroeng Rehabil 2021; 18:7. [PMID: 33436005 PMCID: PMC7805062 DOI: 10.1186/s12984-020-00802-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/20/2020] [Indexed: 01/13/2023] Open
Abstract
Background Braking is a critical determinant of safe driving that depends on the integrity of cognitive and motor processes. Following stroke, both cognitive and motor capabilities are impaired to varying degrees. The current study examines the combined impact of cognitive and motor impairments on braking time in chronic stroke. Methods Twenty stroke survivors and 20 aged-matched healthy controls performed cognitive, motor, and simulator driving assessments. Cognitive abilities were assessed with processing speed, divided attention, and selective attention. Motor abilities were assessed with maximum voluntary contraction (MVC) and motor accuracy of the paretic ankle. Driving performance was examined with the braking time in a driving simulator and self-reported driving behavior. Results Braking time was 16% longer in the stroke group compared with the control group. The self-reported driving behavior in stroke group was correlated with braking time (r = − 0.53, p = 0.02). The stroke group required significantly longer time for divided and selective attention tasks and showed significant decrease in motor accuracy. Together, selective attention time and motor accuracy contributed to braking time (R2 = 0.40, p = 0.01) in stroke survivors. Conclusions This study provides novel evidence that decline in selective attention and motor accuracy together contribute to slowed braking in stroke survivors. Driving rehabilitation after stroke may benefit from the assessment and training of attentional and motor skills to improve braking during driving.
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Affiliation(s)
- Neha Lodha
- Department of Health and Exercise Science, Movement Neuroscience and Rehabilitation Laboratory, Colorado State University, Fort Collins, CA, 80523, USA.
| | - Prakruti Patel
- Department of Health and Exercise Science, Movement Neuroscience and Rehabilitation Laboratory, Colorado State University, Fort Collins, CA, 80523, USA
| | - Joanna M Shad
- Department of Health and Exercise Science, Movement Neuroscience and Rehabilitation Laboratory, Colorado State University, Fort Collins, CA, 80523, USA
| | | | - Evangelos A Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
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Mikula L, Mejía-Romero S, Chaumillon R, Patoine A, Lugo E, Bernardin D, Faubert J. Eye-head coordination and dynamic visual scanning as indicators of visuo-cognitive demands in driving simulator. PLoS One 2020; 15:e0240201. [PMID: 33382720 PMCID: PMC7774948 DOI: 10.1371/journal.pone.0240201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/16/2020] [Indexed: 12/02/2022] Open
Abstract
Driving is an everyday task involving a complex interaction between visual and cognitive processes. As such, an increase in the cognitive and/or visual demands can lead to a mental overload which can be detrimental for driving safety. Compiling evidence suggest that eye and head movements are relevant indicators of visuo-cognitive demands and attention allocation. This study aims to investigate the effects of visual degradation on eye-head coordination as well as visual scanning behavior during a highly demanding task in a driving simulator. A total of 21 emmetropic participants (21 to 34 years old) performed dual-task driving in which they were asked to maintain a constant speed on a highway while completing a visual search and detection task on a navigation device. Participants did the experiment with optimal vision and with contact lenses that introduced a visual perturbation (myopic defocus). The results indicate modifications of eye-head coordination and the dynamics of visual scanning in response to the visual perturbation induced. More specifically, the head was more involved in horizontal gaze shifts when the visual needs were not met. Furthermore, the evaluation of visual scanning dynamics, based on time-based entropy which measures the complexity and randomness of scanpaths, revealed that eye and gaze movements became less explorative and more stereotyped when vision was not optimal. These results provide evidence for a reorganization of both eye and head movements in response to increasing visual-cognitive demands during a driving task. Altogether, these findings suggest that eye and head movements can provide relevant information about visuo-cognitive demands associated with complex tasks. Ultimately, eye-head coordination and visual scanning dynamics may be good candidates to estimate drivers' workload and better characterize risky driving behavior.
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Affiliation(s)
- Laura Mikula
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Sergio Mejía-Romero
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Romain Chaumillon
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Amigale Patoine
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Eduardo Lugo
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Delphine Bernardin
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Essilor International, Research and Development Department, Paris, France & Essilor Canada, Saint-Laurent, Canada
| | - Jocelyn Faubert
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec, Canada
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15
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Shen Y, Zahoor O, Tan X, Usama M, Brijs T. Assessing Fitness-To-Drive among Older Drivers: A Comparative Analysis of Potential Alternatives to on-Road Driving Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8886. [PMID: 33260453 PMCID: PMC7730871 DOI: 10.3390/ijerph17238886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 11/20/2022]
Abstract
To enable older drivers to maintain mobility without endangering public safety, it is necessary to develop more effective means of assessing their fitness-to-drive as alternatives to an on-road driving test. In this study, a functional ability test, simulated driving test, and on-road driving test were carried out for 136 older drivers. Influencing factors related to fitness-to-drive were selected based on the correlation between the outcome measure of each test and the pass/fail outcome of the on-road driving test. Four potential alternatives combining different tests were considered and three modeling techniques were compared when constructing the fitness-to-drive assessment model for the elderly. As a result, 92 participants completed all of the tests, of which 61 passed the on-road driving test and the remaining 31 failed. A total of seven influencing factors from all types of tests were selected. The best model was trained by the technique of gradient boosted machine using all of the seven factors, generating the highest accuracy of 92.8%, with sensitivity of 0.94 and specificity of 0.90. The proposed fitness-to-drive assessment method is considered an effective alternative to the on-road driving test, and the results offer a valuable reference for those unfit-to-drive older drivers to either adjust their driving behavior or cease driving.
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Affiliation(s)
- Yongjun Shen
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
- Transportation Research Institute (IMOB), Hasselt University, 3500 Hasselt, Belgium;
| | - Onaira Zahoor
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
| | - Xu Tan
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
| | - Muhammad Usama
- School of Transportation, Southeast University, Nanjing 211189, China; (O.Z.); (X.T.); (M.U.)
| | - Tom Brijs
- Transportation Research Institute (IMOB), Hasselt University, 3500 Hasselt, Belgium;
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Bell T, Pope C, Fazeli P, Crowe M, Ball K. The Association of Persistent Low Back Pain With Older Adult Falls and Collisions: A Longitudinal Analysis. J Appl Gerontol 2020; 40:1455-1464. [PMID: 33095077 DOI: 10.1177/0733464820966517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mobility-related injuries associate with reduced quality of life, greater functional dependence, and quicker mortality in older adults-warranting prevention efforts. One factor elevating injury risk may be persistent low back pain, which can negatively affect cognitive and physical functions essential for safe mobility. Among older adults obtaining license renewal (n = 1,127), this study examined the association between persistent low back pain and incidence of falls and motor vehicle collisions (MVCs) for up to 15 years. Overall, older adults with persistent low back pain were more likely to have a fall (odds ratio [OR] = 1.54, 95% confidence interval [CI] = [1.34, 1.77]) or MVC (OR = 1.38, 95% CI = [1.07, 1.77]) than those without back pain. Furthermore, the number of falls and MVCs was lower for people with better lower limb and visuospatial function, respectively. Ameliorating pain and functioning in persistent lower back pain might contribute to improved mobility and a reduction of injury-related risk in later life.
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Randomized Crossover Trial Evaluating the Impact of Senofilcon A Photochromic Lens on Driving Performance. Optom Vis Sci 2020; 97:15-23. [PMID: 31895273 PMCID: PMC6946103 DOI: 10.1097/opx.0000000000001466] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
SIGNIFICANCE The first contact lens to incorporate a photochromic additive was cleared by the U.S. Food and Drug Administration last year. Because any ophthalmic lens that absorbs visible wavelengths will reduce retinal illuminance, it is important to understand the impact of this new photochromic contact lens on vision and both daytime and nighttime driving performance. PURPOSE The purpose of this study was to evaluate the effect of senofilcon A photochromic contact lens wear on vision and driving performance under real-world conditions by comparison with a nonphotochromic contact lens and plano photochromic spectacles. METHODS In this randomized four-visit bilateral crossover study, 24 licensed regular drivers and established wearers of soft contact lenses were enrolled. Subjects wore in random order each of three study lens types: the investigational photochromic soft contact lens (test), a nonphotochromic soft contact lens (control 1), and plano photochromic spectacle lenses (control 2). Driver performance was assessed on a closed-circuit driving track under challenging controlled conditions. The primary endpoint was overall driving performance score calculated as a composite Z score of six objective metrics. RESULTS All 24 subjects (mean age, 29.8 years) completed the study. For nighttime driving, the adjusted mean differences in Z score (95% confidence interval) between test and control 1 and between test and control 2 were 0.069 (−0.045 to +0.183) and 0.117 (0.003 to 0.231), respectively. For daytime driving, mean differences were 0.101 (−0.013 to +0.216) between test and control 1 and 0.044 (−0.070 to +0.158) between test and control 2. Results demonstrated noninferiority of the test lens relative to controls for nighttime and daytime driving performance using a noninferiority margin of −0.25 Z score. Noninferiority was also demonstrated on all logMAR and contrast threshold testing. No adverse events were reported during the study. CONCLUSIONS Study results revealed no evidence of concerns with either driving performance or vision while wearing photochromic contact lenses.
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18
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When cognitive control harms rather than helps: individuals with high working memory capacity are less efficient at infrequent contraction of attentional breadth. PSYCHOLOGICAL RESEARCH 2020; 85:1783-1800. [DOI: 10.1007/s00426-020-01344-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 04/13/2020] [Indexed: 12/25/2022]
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Lee SSY, Wood JM, Black AA. Impact of glaucoma on executive function and visual search. Ophthalmic Physiol Opt 2020; 40:333-342. [PMID: 32189400 DOI: 10.1111/opo.12679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/06/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Executive function and visual search are linked to a number of activities of daily living including driving and mobility. Using a computerised version of the Trail Making Test B (TMT-B), we compared the executive function and visual search ability of older adults with glaucoma to age-similar controls and identified which visual function tests best predict TMT-B performance. Novel low-contrast and shifting-target variations of the test were incorporated to explore the effects of different levels of test complexity. METHODS Thirty-one older adults with mild to moderate glaucoma (mean age = 71.2 years [SD 6.9]; better-eye mean deviation [MD]: median = -1.9 dB [IQR = -1.2 to 0.4], worse-eye MD: median = -11.1 dB [IQR = -14.0 to -7.7]) and 24 age-similar controls (mean age = 71.9 years [SD 6.6]) with normal vision participated. The groups were matched in age, sex, and cognitive status (mini-mental state examination [MMSE]). Participants underwent measurements of visual acuity, contrast sensitivity (CS), visual fields, and visual processing speeds using the useful field-of-view (UFoV). Participants then completed four variations of a computerised TMT-B test, with different levels of complexity based on target contrast (high/low-contrast) and shifts in target position (fixed/shifting locations). Linear mixed-effect models were used to explore the effects of group, target contrast and shift on TMT-B completion time. RESULTS The glaucoma group took 17.3s longer than controls to complete the TMT-B (P = 0.028). All participants took 6.5s longer to complete the low- compared to the high-contrast tests (P = 0.012), and 10.6s longer for the shifting TMT-B compared to the fixed version (P < 0.001). There was no interaction effect between group, contrast, or target shift on completion time. Across all tests and participant groups, longer completion time was associated with slower UFoV processing speeds (divided attention: P = 0.003; selective attention: P = 0.006). Poorer CS was associated with longer completion times for the low (P = 0.007), but not the high-contrast tests. CONCLUSIONS Our findings suggest that older adults with mild to moderate glaucoma have poorer visual search ability and executive function relative to controls. However, decreasing target contrast or shifting target position did not exacerbate the effects of glaucomatous visual impairment on performance. The UFoV was a strong predictor of TMT-B performance.
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Affiliation(s)
- Samantha Sze-Yee Lee
- School of Optometry and Vision Science, and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Lions Eye Institute, Centre for Ophthalmology and Visual Sciences, University of Western Australia, Perth, Australia
| | - Joanne M Wood
- School of Optometry and Vision Science, and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Alexander A Black
- School of Optometry and Vision Science, and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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20
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Zou X, Vu HL. Mapping the knowledge domain of road safety studies: A scientometric analysis. ACCIDENT; ANALYSIS AND PREVENTION 2019; 132:105243. [PMID: 31494404 DOI: 10.1016/j.aap.2019.07.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/11/2019] [Accepted: 07/20/2019] [Indexed: 06/10/2023]
Abstract
As a way of obtaining a visual expression of knowledge, mapping knowledge domain (MKD) provides a vision-based analytic approach to scientometric analysis which can be used to reveal an academic community, the structure of its networks, and the dynamic development of a discipline. This study, based on the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) articles on road safety, employs the bibliometric tools VOSviewer and CitNetExplorer to create maps of author co-citation, document co-citation, citation networks, analyze the core authors and classic documents supporting road safety studies and show the citation context and development of such studies. It shows that road safety studies clustered mainly into four groups, whose we will refer to as "effects of driving psychology and behavior on road safety", "causation, frequency and injury severity analysis of road crashes", "epidemiology, assessment and prevention of road traffic injury", and "effects of driver risk factors on driver performance and road safety", respectively. Through our analysis, the core publications and their citation relationships were quickly located and explored, and "crash frequency modeling analysis" has been identified to be the core research topic in road safety studies, with spatial statistical analysis technique emerging as a frontier of this topic.
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Affiliation(s)
- Xin Zou
- Institute of Transport Studies, Monash University, Clayton, VIC, 3800, Australia.
| | - Hai L Vu
- Institute of Transport Studies, Monash University, Clayton, VIC, 3800, Australia
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21
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Yan MK, Kumar H, Kerr N, Medeiros FA, Sandhu SS, Crowston J, Kong YXG. Transnational review of visual standards for driving: How Australia compares with the rest of the world. Clin Exp Ophthalmol 2019; 47:847-863. [DOI: 10.1111/ceo.13572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 05/11/2019] [Accepted: 05/18/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Mabel K. Yan
- The Ophthalmology DepartmentAlfred Hospital Melbourne Victoria Australia
- Clinical Research DepartmentCentre for Eye Research Australia Melbourne Victoria Australia
| | - Himeesh Kumar
- The Ophthalmology DepartmentAlfred Hospital Melbourne Victoria Australia
- Clinical Research DepartmentCentre for Eye Research Australia Melbourne Victoria Australia
| | - Nathan Kerr
- Clinical Research DepartmentCentre for Eye Research Australia Melbourne Victoria Australia
- Ophthalmology DepartmentRoyal Victorian Eye and Ear Hospital Victoria Australia
| | | | - Sukhpal S. Sandhu
- Clinical Research DepartmentCentre for Eye Research Australia Melbourne Victoria Australia
- Ophthalmology DepartmentRoyal Victorian Eye and Ear Hospital Victoria Australia
| | - Jonathan Crowston
- Clinical Research DepartmentCentre for Eye Research Australia Melbourne Victoria Australia
- Ophthalmology DepartmentRoyal Victorian Eye and Ear Hospital Victoria Australia
- Centre for Vision ResearchDuke‐NUS Medical School Singapore Singapore
| | - Yu X. G. Kong
- Clinical Research DepartmentCentre for Eye Research Australia Melbourne Victoria Australia
- Ophthalmology DepartmentRoyal Victorian Eye and Ear Hospital Victoria Australia
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22
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Metzler MJ, Maiani M, Jamieson B, Dukelow SP. Clinical provision of compensatory visual training after neurological injury: example of a multisite outpatient program. Disabil Rehabil 2019; 43:118-125. [PMID: 31120310 DOI: 10.1080/09638288.2019.1616835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM Treatment efficacy is established via controlled research trials, but treatment in real-world clinical environments is typically highly variable and may differ from research protocols by necessity. Here, we examined provision of visual retraining for adults after neurological injury at an outpatient rehabilitation program in Calgary, Canada. METHODS Retrospective chart audits extracted demographic data, assessment outcomes, and details related to provision of training. RESULTS Treatment was provided to individuals with both visual field and visual-perceptual impairments due to neurological injury (mostly stroke). Tools and techniques of visual retraining at this program are discussed, the common denominator being repetitive practice of compensatory visual behaviors. Across this multisite program, there was significant variability in the number of treatment sessions, 13.00 (±10.21) sessions for those with visual-perceptual impairments and 14.41 (±9.63) sessions for those with field loss. Descriptive statistics and confidence intervals suggest improved outcomes on some measures for those with visual field and visual perceptual impairments. CONCLUSIONS Our data suggest that visual retraining is feasible in this clinical outpatient setting. Implications for rehabilitation This program of visual retraining was provided to individuals with visual impairment (e.g., hemianopia) and visual perceptual impairment (e.g., unilateral spatial neglect) as a result of neurological injury. In this outpatient program, visual rehabilitation was feasible and appeared to improve outcomes among a heterogeneous clinical population. Fundamental characteristics of visual compensatory training at this program included repetitive practice of adaptive scanning behaviors across multiple contexts to promote automaticity and generalization of skills.
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Affiliation(s)
- Megan J Metzler
- Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, Canada
| | - Meghan Maiani
- Community Accessible Rehabilitation, Alberta Health Services, Calgary, Canada
| | - Brittany Jamieson
- Community Accessible Rehabilitation, Alberta Health Services, Calgary, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
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Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer's Disease. J Int Neuropsychol Soc 2018; 24:486-497. [PMID: 29283079 PMCID: PMC5910249 DOI: 10.1017/s1355617717001291] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Patients with Alzheimer's disease (AD) demonstrate deficits in cross-cortical feature binding distinct from age-related changes in selective attention. This may have consequences for driving performance given its demands on multisensory integration. We examined the relationship of visuospatial search and binding to driving in patients with early AD and elderly controls (EC). METHODS Participants (42 AD; 37 EC) completed search tasks requiring either luminance-motion (L-M) or color-motion (C-M) binding, analogs of within and across visual processing stream binding, respectively. Standardized road test (RIRT) and naturalistic driving data (CDAS) were collected alongside clinical screening measures. RESULTS Patients performed worse than controls on most cognitive and driving indices. Visual search and clinical measures were differentially related to driving behavior across groups. L-M search and Trail Making Test (TMT-B) were associated with RIRT performance in controls, while C-M binding, TMT-B errors, and Clock Drawing correlated with CDAS performance in patients. After controlling for demographic and clinical predictors, L-M reaction time significantly predicted RIRT performance in controls. In patients, C-M binding made significant contributions to CDAS above and beyond demographic and clinical predictors. RIRT and C-M binding measures accounted for 51% of variance in CDAS performance in patients. CONCLUSIONS Whereas selective attention is associated with driving behavior in EC, cross-cortical binding appears most sensitive to driving in AD. This latter relationship may emerge only in naturalistic settings, which better reflect patients' driving behavior. Visual integration may offer distinct insights into driving behavior, and thus has important implications for assessing driving competency in early AD. (JINS, 2018, 24, 486-497).
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Bell T, Mirman JH, Stavrinos D. Pain, Pain Catastrophizing, and Individual Differences in Executive Function in Adolescence. CHILDRENS HEALTH CARE 2018; 48:18-37. [PMID: 31571719 DOI: 10.1080/02739615.2018.1441028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Many adolescents will experience pain at some point in their development that can lead to poor quality of life. The largest risk factor for pain is tendencies to magnify and ruminate on pain, known as pain catastrophizing. One mechanism of catastrophizing may be difficulties with executive function, or the ability to cognitively control information. The objective of the current study was to determine if adolescent executive function difficulties relate to high catastrophizing and pain. Fifty adolescents completed measures of pain, pain catastrophizing, and executive function. Path models revealed relations among gender, executive function domains, pain catastrophizing domains, and pain. In general, pain catastrophizing was associated with problems with shifting and inhibition. Females reported high catastrophizing and pain, partially explained by executive function difficulty. Executive function difficulty may help clinicians identify adolescents prone to catastrophize painful events. Interventions addressing these difficulties may reduce catastrophizing as well as pain intensity and duration.
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Affiliation(s)
- Tyler Bell
- Department of Psychology, University of Alabama at Birmingham
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Edwards JD, Fausto BA, Tetlow AM, Corona RT, Valdés EG. Systematic review and meta-analyses of useful field of view cognitive training. Neurosci Biobehav Rev 2018; 84:72-91. [DOI: 10.1016/j.neubiorev.2017.11.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 11/04/2017] [Accepted: 11/06/2017] [Indexed: 12/30/2022]
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Michaels J, Chaumillon R, Nguyen-Tri D, Watanabe D, Hirsch P, Bellavance F, Giraudet G, Bernardin D, Faubert J. Driving simulator scenarios and measures to faithfully evaluate risky driving behavior: A comparative study of different driver age groups. PLoS One 2017; 12:e0185909. [PMID: 29016693 PMCID: PMC5634611 DOI: 10.1371/journal.pone.0185909] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 09/21/2017] [Indexed: 11/23/2022] Open
Abstract
To investigate the links between mental workload, age and risky driving, a cross-sectional study was conducted on a driving simulator using several established and some novel measures of driving ability and scenarios of varying complexity. A sample of 115 drivers was divided into three age and experience groups: young inexperienced (18-21 years old), adult experienced (25-55 years old) and older adult (70-86 years old). Participants were tested on three different scenarios varying in mental workload from low to high. Additionally, to gain a better understanding of individuals' ability to capture and integrate relevant information in a highly complex visual environment, the participants' perceptual-cognitive capacity was evaluated using 3-dimensional multiple object tracking (3D-MOT). Results indicate moderate scenario complexity as the best suited to highlight well-documented differences in driving ability between age groups and to elicit naturalistic driving behavior. Furthermore, several of the novel driving measures were shown to provide useful, non-redundant information about driving behavior, complementing more established measures. Finally, 3D-MOT was demonstrated to be an effective predictor of elevated crash risk as well as decreased naturally-adopted mean driving speed, particularly among older adults. In sum, the present experiment demonstrates that in cases of either extreme high or low task demands, drivers can become overloaded or under aroused and thus task measures may lose sensitivity. Moreover, insights from the present study should inform methodological considerations for future driving simulator research. Importantly, future research should continue to investigate the predictive utility of perceptual-cognitive tests in the domain of driving risk assessment.
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Affiliation(s)
- Jesse Michaels
- Visual Psychophysics and Perception Laboratory, School of Optometry, Université de Montréal, Montréal, Quebec, Canada
| | - Romain Chaumillon
- Visual Psychophysics and Perception Laboratory, School of Optometry, Université de Montréal, Montréal, Quebec, Canada
| | - David Nguyen-Tri
- Visual Psychophysics and Perception Laboratory, School of Optometry, Université de Montréal, Montréal, Quebec, Canada
| | - Donald Watanabe
- Visual Psychophysics and Perception Laboratory, School of Optometry, Université de Montréal, Montréal, Quebec, Canada
| | | | - Francois Bellavance
- Interuniversity Research Centre on Enterprise Networks, Logistics and Transportation (CIRRELT) and Department of Management Sciences, HEC Montréal, Montréal, Canada
| | - Guillaume Giraudet
- Visual Psychophysics and Perception Laboratory, School of Optometry, Université de Montréal, Montréal, Quebec, Canada
- Essilor International, R&D, Paris, France
| | - Delphine Bernardin
- Visual Psychophysics and Perception Laboratory, School of Optometry, Université de Montréal, Montréal, Quebec, Canada
- Essilor Canada Ltd., Montréal, Quebec, Canada
| | - Jocelyn Faubert
- Visual Psychophysics and Perception Laboratory, School of Optometry, Université de Montréal, Montréal, Quebec, Canada
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A cognitive function predicted method by Useful Field of View tests among elder people in Beijing. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2017. [DOI: 10.1016/j.jtcms.2017.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Edwards JD, Lister JJ, Lin FR, Andel R, Brown L, Wood JM. Association of Hearing Impairment and Subsequent Driving Mobility in Older Adults. THE GERONTOLOGIST 2017; 57:767-775. [PMID: 26916667 PMCID: PMC5881668 DOI: 10.1093/geront/gnw009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/10/2015] [Indexed: 11/14/2022] Open
Abstract
Purpose of the Study Hearing impairment (HI) is associated with driving safety (e.g., increased crashes and poor on-road driving performance). However, little is known about HI and driving mobility. This study examined the longitudinal association of audiometric hearing with older adults' driving mobility over 3 years. Design and Methods Secondary data analyses were conducted of 500 individuals (63-90 years of age) from the Staying Keen in Later Life (SKILL) study. Hearing (pure tone average of 0.5, 1, and 2kHz) was assessed in the better hearing ear and categorized into normal hearing ≤25 dB hearing level (HL); mild HI 26-40 dB HL; or moderate and greater HI ≥41 dB HL. The Useful Field of View Test (UFOV) was used to estimate the risk for adverse driving events. Multivariate analysis of covariance compared driving mobility between HI levels across time, adjusting for age, sex, race, hypertension, and stroke. Adjusting for these same covariates, Cox regression analyses examined incidence of driving cessation by HI across 3 years. Results Individuals with moderate or greater HI performed poorly on the UFOV, indicating increased risk for adverse driving events (p < .001). No significant differences were found among older adults with varying levels of HI for driving mobility (p values > .05), including driving cessation rates (p = .38), across time. Implications Although prior research indicates older adults with HI may be at higher risk for crashes, they may not modify driving over time. Further exploration of this issue is required to optimize efforts to improve driving safety and mobility among older adults.
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Affiliation(s)
| | - Jennifer J. Lister
- Department of Communication Sciences and Disorders, University of South Florida, Tampa
| | - Frank R. Lin
- Department of Otolaryngology and
- Department of Geriatric Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Ross Andel
- School of Aging Studies and
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
| | - Lisa Brown
- Pacific Graduate School of Psychology, Palo Alto University, California
| | - Joanne M. Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Lassen-Greene CL, Steward K, Okonkwo O, Porter E, Crowe M, Vance DE, Griffith HR, Ball K, Marson DC, Wadley VG. Mild Cognitive Impairment and Changes in Everyday Function Over Time: The Importance of Evaluating Both Speed and Accuracy. J Geriatr Psychiatry Neurol 2017; 30:220-227. [PMID: 28639877 PMCID: PMC5812285 DOI: 10.1177/0891988717711807] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Research estimates that a significant percentage of individuals with mild cognitive impairment (MCI) experience functional difficulties. In addition to reduced accuracy on measures of everyday function, cross-sectional research has demonstrated that speed of performing instrumental activities of daily living (IADLs) is slowed in individuals with MCI. The present study investigated whether baseline and longitudinal changes in speed and accuracy of IADL performance differed between persons with MCI and cognitively normal peers. DESIGN Linear mixed models were used to estimate the group differences in longitudinal performance on measures of IADLs. SETTING Assessments were conducted at university and medical research centers. PARTICIPANTS The sample consisted of 80 participants with MCI and 80 control participants who were enrolled in the Alzheimer's Disease Research Center's Measuring Independent Living in the Elderly Study. MEASUREMENTS Instrumental activities of daily living speed and accuracy were directly assessed using selected domains of the Financial Capacity Instrument, the Timed IADL assessment, and driving-related assessments (Useful Field of View, Road Sign Test). RESULTS Individuals with MCI performed worse on speed and accuracy measures of IADLs in comparison to cognitively normal peers and demonstrated significantly steeper rates of decline over three years in either speed or accuracy in all domains assessed. CONCLUSION Both speed and accuracy of performance on measures of IADL are valuable indices for early detection of functional change in MCI. The performance pattern may reflect a trade-off between speed and accuracy that can guide clinical recommendations for maintaining patient independence.
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Affiliation(s)
| | - Kayla Steward
- Department of Psychology, University of Alabama at Birmingham (UAB)
| | | | | | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham (UAB)
| | | | | | - Karlene Ball
- Department of Psychology, University of Alabama at Birmingham (UAB)
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Wiese LK, Wolff L. Supporting Safety in the Older Adult Driver: A Public Health Nursing Opportunity. Public Health Nurs 2016; 33:460-71. [PMID: 27263475 DOI: 10.1111/phn.12274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The effective operation of a motor vehicle encompasses a wide range of cognitive processes that can decline due to age-related changes in neuroanatomical structures and cognitive functionality. The increasing number of older adult drivers in our rapidly aging population heightens the public safety concern of unsafe driving associated with these changes. Nurses caring for older adults in public health settings are well positioned to make a difference in the management of older patients who may be at risk of endangering themselves or others on the roadways. In this article, information is provided for increasing nurses' awareness of the cognitive factors inhibiting effective driving, recognizing older adults who may be at risk for unsafe driving, and facilitating a patient/family to seek a driving evaluation.
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Affiliation(s)
- Lisa Kirk Wiese
- C.E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida.
| | - Logan Wolff
- College of Psychology, Nova Southeastern University, Fort Lauderdale, Florida
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Aust F, Edwards JD. Incremental validity of Useful Field of View subtests for the prediction of instrumental activities of daily living. J Clin Exp Neuropsychol 2016; 38:497-515. [PMID: 26782018 DOI: 10.1080/13803395.2015.1125453] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults' ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions, and the underlying constructs of UFOV performance remain a topic of debate. METHOD We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We then explored the cognitive and visual abilities assessed by UFOV using a range of neuropsychological and vision tests administered in the SKILL study. RESULTS In the four subtest variant of UFOV, only Subtests 2 and 3 consistently made independent contributions to the prediction of IADL performance across three different behavioral measures. In all cases, the incremental validity of UFOV Subtests 1 and 4 was negligible. Furthermore, we found that UFOV was related to processing speed, general nonspeeded cognition, and visual function; the omission of Subtests 1 and 4 from the test score did not affect these associations. CONCLUSIONS UFOV Subtests 1 and 4 appear to be of limited use to predict IADL and possibly other everyday activities. Future research should investigate whether shortening UFOV by omitting these subtests is a reliable and valid assessment approach.
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Affiliation(s)
- Frederik Aust
- a Department of Psychology , University of Cologne , Cologne , Germany
| | - Jerri D Edwards
- b School of Aging Studies , University of South Florida , Tampa , FL , USA
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Hill-Jarrett TG, Gravano JT, Sozda CN, Perlstein WM. Visuospatial attention after traumatic brain injury: The role of hemispheric specialization. Brain Inj 2015; 29:1617-29. [PMID: 26451899 DOI: 10.3109/02699052.2015.1075155] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To evaluate the behavioural and neural effects of TBI on the hemispheric integrity of three components of visuospatial attention: alerting, orienting and executive control. METHOD Behavioural performance and high density event-related potentials (ERPs) were acquired while a sample of 12 patients with chronic moderate-to-severe TBI and 12 controls performed the Lateralized Attention Network Test (LANT). Neural indices of attention (posterior N1 amplitude to alerting and orienting cues, midline P3 amplitude during conflict resolution) were examined. RESULTS Patients with TBI exhibited smaller N1 amplitude to alerting cues, but comparable behavioural performance to controls. Participants with TBI also demonstrated poorer orienting performance to the left hemispace relative to the right. A corresponding reduction in right hemisphere N1 was found during left orienting to spatial cues in the TBI group. No group differences were observed on behavioural measures of executive control; however, patients with TBI exhibited reduced P3 amplitude overall. CONCLUSIONS TBI may have an enduring effect on the orienting system at both neural and behavioural levels. Assessment of attention in chronic TBI can be improved by the integration of hemispheric findings that suggest disproportionate vulnerability in leftward orienting. Results may enhance clinical sensitivity to detection of subtle signs of neglect.
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Affiliation(s)
- Tanisha G Hill-Jarrett
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | - Jason T Gravano
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | | | - William M Perlstein
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA .,c VA RR&D Brain Rehabilitation and Research Center of Excellence , Malcom Randall VA, Gainesville, FL , USA
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Agathos CP, Bernardin D, Huchet D, Scherlen AC, Assaiante C, Isableu B. Sensorimotor and cognitive factors associated with the age-related increase of visual field dependence: a cross-sectional study. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9805. [PMID: 26122710 PMCID: PMC4485658 DOI: 10.1007/s11357-015-9805-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 06/21/2015] [Indexed: 06/04/2023]
Abstract
Reliance on the visual frame of reference for spatial orientation (or visual field dependence) has been reported to increase with age. This has implications on old adults' daily living tasks as it affects stability, attention, and adaptation capacities. However, the nature and underlying mechanisms of this increase are not well defined. We investigated sensorimotor and cognitive factors possibly associated with increased visual field dependence in old age, by considering functions that are both known to degrade with age and important for spatial orientation and sensorimotor control: reliance on the (somatosensory-based) egocentric frame of reference, visual fixation stability, and attentional processing of complex visual scenes (useful field of view, UFOV). Twenty young, 18 middle-aged, and 20 old adults completed a visual examination, three tests of visual field dependence (RFT, RDT, and GEFT), a test of egocentric dependence (subjective vertical estimation with the body erect and tilted at 70°), a visual fixation task, and a test of visual attentional processing (UFOV®). Increased visual field dependence with age was associated with reduced egocentric dependence, visual fixation stability, and visual attentional processing. In addition, visual fixation instability and reduced UFOV were correlated. Results of middle-aged adults fell between those of the young and old, revealing the progressive nature of the age effects we evaluated. We discuss results in terms of reference frame selection with respect to ageing as well as visual and non-visual information processing. Inter-individual differences amongst old adults are highlighted and discussed with respect to the functionality of increased visual field dependence.
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Affiliation(s)
- Catherine P Agathos
- R&D Optics Department, Vision Sciences Department, Essilor International, 75012, Paris, France,
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Abstract
PURPOSE Driving is a vision-based activity of daily living that impacts safety. Because visual disruption can compromise driving safety, contact lens wearers with astigmatism may pose a driving safety risk if they experience residual blur from spherical lenses that do not correct their astigmatism or if they experience blur from toric lenses that rotate excessively. Given that toric lens stabilization systems are continually improving, this preliminary study tested the hypothesis that astigmats wearing toric contact lenses, compared with spherical lenses, would exhibit better overall driving performance and driving-specific visual abilities. METHODS A within-subject, single-blind, crossover, randomized design was used to evaluate driving performance in 11 young adults with astigmatism (-0.75 to -1.75 diopters cylinder). Each participant drove a highly immersive, virtual reality driving simulator (210 degrees field of view) with (1) no correction, (2) spherical contact lens correction (ACUVUE MOIST), and (3) toric contact lens correction (ACUVUE MOIST for Astigmatism). Tactical driving skills such as steering, speed management, and braking, as well as operational driving abilities such as visual acuity, contrast sensitivity, and foot and arm reaction time, were quantified. RESULTS There was a main effect for type of correction on driving performance (p = 0.05). Correction with toric lenses resulted in significantly safer tactical driving performance than no correction (p < 0.05), whereas correction with spherical lenses did not differ in driving safety from no correction (p = 0.118). Operational tests differentiated corrected from uncorrected performance for both spherical (p = 0.008) and toric (p = 0.011) lenses, but they were not sensitive enough to differentiate toric from spherical lens conditions. CONCLUSIONS Given previous research showing that deficits in these tactical skills are predictive of future real-world collisions, these preliminary data suggest that correcting low to moderate astigmatism with toric lenses may be important to driving safety. Their merits relative to spherical lens correction require further investigation.
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Elliott AF, O'Connor ML, Edwards JD. Cognitive speed of processing training in older adults with visual impairments. Ophthalmic Physiol Opt 2015; 34:509-18. [PMID: 25160890 DOI: 10.1111/opo.12148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 06/30/2014] [Indexed: 02/01/2023]
Abstract
PURPOSE To examine whether older adults with vision impairment differentially benefit from cognitive speed of processing training (SPT) relative to healthy older adults. METHODS Secondary data analyses were conducted from a randomised trial on the effects of SPT among older adults. The effects of vision impairment as indicated by (1) near visual acuity, (2) contrast sensitivity, (3) self-reported cataracts and (4) self-reported other eye conditions (e.g., glaucoma, macular degeneration, diabetic retinopathy, optic neuritis, and retinopathy) among participants randomised to either SPT or a social- and computer-contact control group was assessed. The primary outcome was Useful Field of View Test (UFOV) performance. RESULTS Mixed repeated-measures ancovas demonstrated that those randomized to SPT experienced greater baseline to post-test improvements in UFOV performance relative to controls (p's < 0.001), regardless of impairments in near visual acuity, contrast sensitivity or presence of cataracts. Those with other eye conditions significantly benefitted from training (p = 0.044), but to a lesser degree than those without such conditions. Covariates included age and baseline measures of balance and depressive symptoms, which were significantly correlated with baseline UFOV performance. CONCLUSIONS Among a community-based sample of older adults with and without visual impairment and eye disease, the SPT intervention was effective in enhancing participants' UFOV performance. The analyses presented here indicate the potential for SPT to enhance UFOV performance among a community-based sample of older adults with visual impairment and potentially for some with self-reported eye disease; further research to explore this area is warranted, particularly to determine the effects of eye diseases on SPT benefits.
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Alhasani R, Nayak A, Szturm T, Nankar M, Boreskie S, Brousseau G. The Feasibility of a Novel Dual-Task Exercise Program Which Integrates Balance, Gaze, Mobility and Cognition in Community Dwelling Older Adults: Protocol for a Randomized Clinical Pilot Trial. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/aar.2015.43012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Szturm T, Sakhalkar V, Boreskie S, Marotta JJ, Wu C, Kanitkar A. Integrated testing of standing balance and cognition: test-retest reliability and construct validity. Gait Posture 2015; 41:146-52. [PMID: 25455701 DOI: 10.1016/j.gaitpost.2014.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 02/02/2023]
Abstract
Balance and cognitive impairments which are common with aging often coexist, are prognostic of future adverse health events, including fall injuries. Consequently, dual-task assessment programs that simultaneously address both stability and cognition are important to consider in rehabilitation and benefit healthy aging. The objective of this study was to establish test-retest reliability and construct validity of a dual-task computer game-based platform (TGP) that integrates head tracking and cognitive tasks with balance activities. Thirty healthy, community-dwelling individuals median age 64 (range 60-67) were recruited from a certified Medical Fitness Facility. Participants performed a series of computerized head tracking and cognitive game tasks while standing on fixed and sponge surfaces. Testing was conducted on two occasions, one week apart. Moderate to high test retest reliability (ICC values of 0.55-0.75) was observed for all outcome measures representing balance, gaze performance, cognition, and dual-task performance. A significant increase in center of foot pressure (COP) excursion was observed during both head tracking and cognitive dual-task conditions. The results demonstrate the system's ability to reliably detect changes related to specific and integrated aspects of balance, gaze, and cognitive performance.
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Affiliation(s)
- Tony Szturm
- School of Medical Rehabilitation, University of Manitoba, Canada.
| | - Vedant Sakhalkar
- School of Medical Rehabilitation, University of Manitoba, Canada.
| | | | | | - Christine Wu
- Department of Mechanical Engineering, University of Manitoba, Canada; Department of Manufacturing Engineering, University of Manitoba, Canada.
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Wood JM, Lacherez P, Tyrrell RA. Seeing pedestrians at night: effect of driver age and visual abilities. Ophthalmic Physiol Opt 2014; 34:452-8. [PMID: 24888897 DOI: 10.1111/opo.12139] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 05/06/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE To quantify the effects of driver age on night-time pedestrian conspicuity, and to determine whether individual differences in visual performance can predict drivers' ability to recognise pedestrians at night. METHODS Participants were 32 visually normal drivers (20 younger: M = 24.4 years ± 6.4 years; 12 older: M = 72.0 years ± 5.0 years). Visual performance was measured in a laboratory-based testing session including visual acuity, contrast sensitivity, motion sensitivity and the useful field of view. Night-time pedestrian recognition distances were recorded while participants drove an instrumented vehicle along a closed road course at night; to increase the workload of drivers, auditory and visual distracter tasks were presented for some of the laps. Pedestrians walked in place, sideways to the oncoming vehicles, and wore either a standard high visibility reflective vest or reflective tape positioned on the movable joints (biological motion). RESULTS Driver age and pedestrian clothing significantly (p < 0.05) affected the distance at which the drivers first responded to the pedestrians. Older drivers recognised pedestrians at approximately half the distance of the younger drivers and pedestrians were recognised more often and at longer distances when they wore a biological motion reflective clothing configuration than when they wore a reflective vest. Motion sensitivity was an independent predictor of pedestrian recognition distance, even when controlling for driver age. CONCLUSIONS The night-time pedestrian recognition capacity of older drivers was significantly worse than that of younger drivers. The distance at which drivers first recognised pedestrians at night was best predicted by a test of motion sensitivity.
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Affiliation(s)
- Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Abstract
The useful field of view test was developed to reflect the visual difficulties that older adults experience with everyday tasks. Importantly, the useful field of view test (UFOV) is one of the most extensively researched and promising predictor tests for a range of driving outcomes measures, including driving ability and crash risk as well as other everyday tasks. Currently available commercial versions of the test can be administered using personal computers; these measure the speed of visual processing for rapid detection and localization of targets under conditions of divided visual attention and in the presence and absence of visual clutter. The test is believed to assess higher-order cognitive abilities, but performance also relies on visual sensory function because in order for targets to be attended to, they must be visible. The format of the UFOV has been modified over the years; the original version estimated the spatial extent of useful field of view, while the latest version measures visual processing speed. While deficits in the useful field of view are associated with functional impairments in everyday activities in older adults, there is also emerging evidence from several research groups that improvements in visual processing speed can be achieved through training. These improvements have been shown to reduce crash risk, and can have a positive impact on health and functional well-being, with the potential to increase the mobility and hence the independence of older adults.
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Affiliation(s)
- Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Qld., Australia
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The interacting effect of cognitive and motor task demands on performance of gait, balance and cognition in young adults. Gait Posture 2013; 38:596-602. [PMID: 23477841 DOI: 10.1016/j.gaitpost.2013.02.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 01/29/2013] [Accepted: 02/01/2013] [Indexed: 02/02/2023]
Abstract
Mobility limitations and cognitive impairments, each common with aging, reduce levels of physical and mental activity, are prognostic of future adverse health events, and are associated with an increased fall risk. The purpose of this study was to examine whether divided attention during walking at a constant speed would decrease locomotor rhythm, stability, and cognitive performance. Young healthy participants (n=20) performed a visuo-spatial cognitive task in sitting and while treadmill walking at 2 speeds (0.7 and 1.0 m/s).Treadmill speed had a significant effect on temporal gait variables and ML-COP excursion. Cognitive load did not have a significant effect on average temporal gait variables or COP excursion, but variation of gait variables increased during dual-task walking. ML and AP trunk motion was found to decrease during dual-task walking. There was a significant decrease in cognitive performance (success rate, response time and movement time) while walking, but no effect due to treadmill speed. In conclusion walking speed is an important variable to be controlled in studies that are designed to examine effects of concurrent cognitive tasks on locomotor rhythm, pacing and stability. Divided attention during walking at a constant speed did result in decreased performance of a visuo-spatial cognitive task and an increased variability in locomotor rhythm.
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Johnson CA. Psychophysical factors that have been applied to clinical perimetry. Vision Res 2013; 90:25-31. [PMID: 23872241 DOI: 10.1016/j.visres.2013.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 07/01/2013] [Accepted: 07/03/2013] [Indexed: 11/16/2022]
Abstract
Perimetry is the most common clinical diagnostic test procedure for evaluating the status of peripheral visual function in the management of ocular and neurologic diseases. This procedure has an extended history, and its design, implementation and interpretation is dependent on many principles that have been developed through visual psychophysical studies of target size, target duration, background adaptation level, chromatic characteristics and other stimulus properties (see Greve, 1973; Johnson, 1994, chap. 17, 1996, 2008, 2010, chap. 23; Johnson & Keltner, 1998, chap. 7; Johnson & Sample, 2002, chap. 22; Johnson & Wall, 2011, chap. 35; Wall & Johnson, 2005, chap. 2 for reviews). This paper will provide a general overview of the history of perimetry, selection of stimulus parameters, development of test strategies, clinical testing conditions, new procedures and approaches to perimetry, experimental design, analysis and interpretation methods, hypothesis testing, prediction and forecasting procedures, and other related topics. It is somewhat paradoxical that although there have been major advances in all of these areas that have significantly enhanced the utility and value of this clinical diagnostic test, the fundamental methodology has remained mostly unchanged for thousands of years. It is hoped that this overview will be of assistance to investigators and clinicians who wish to use or modify this diagnostic procedure for their ongoing career activities.
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Affiliation(s)
- Chris A Johnson
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1091, USA.
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Bronstad PM, Bowers AR, Albu A, Goldstein R, Peli E. Driving with central field loss I: effect of central scotomas on responses to hazards. JAMA Ophthalmol 2013; 131:303-9. [PMID: 23329309 DOI: 10.1001/jamaophthalmol.2013.1443] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To determine how central field loss (CFL) affects reaction time to pedestrians and to test the hypothesis that scotomas lateral to the preferred retinal locus will delay detection of hazards approaching from that side. METHODS Participants with binocular CFL (scotoma diameter, 7°-25°; visual acuity, 0.3-1.0 logMAR) using lateral preferred retinal fixation loci and matched controls with normal vision drove in a simulator for approximately 1½ hours per session for 2 sessions a week apart. Participants responded to frequent virtual pedestrians who appeared on either the left or right sides and approached the participant's lane on a collision trajectory that, therefore, caused them to remain in approximately the same area of the visual field. RESULTS The study included 11 individuals with CFL and 11 controls with normal vision. The CFL participants had more detection failures for pedestrians who appeared in areas of visual field loss than did controls in corresponding areas (6.4% vs 0.2%). Furthermore, the CFL participants reacted more slowly to pedestrians in blind than nonscotomatous areas (4.28 vs 2.43 seconds, P < .001) and overall had more late and missed responses than controls (29% vs 3%, P < .001). Scotoma size and contrast sensitivity predicted outcomes in blind and seeing areas, respectively. Visual acuity was not correlated with response measures. CONCLUSIONS In addition to causing visual acuity and contrast sensitivity loss, the central scotoma per se delayed hazard detection even though small eye movements could potentially compensate for the loss. Responses in nonscotomatous areas were also delayed, although to a lesser extent, possibly because of the eccentricity of fixation. Our findings will help practitioners advise patients with CFL about specific difficulties they may face when driving.
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Prevention, Rehabilitation, and Mitigation Strategies of Cognitive Deficits in Aging with HIV: Implications for Practice and Research. ISRN NURSING 2013; 2013:297173. [PMID: 23431469 PMCID: PMC3574749 DOI: 10.1155/2013/297173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 12/21/2012] [Indexed: 11/25/2022]
Abstract
Highly active antiretroviral therapy has given the chance to those living with HIV to keep on living, allowing them the opportunity to age and perhaps age successfully. Yet, there are severe challenges to successful aging with HIV, one of which is cognitive deficits. Nearly half of those with HIV experience cognitive deficits that can interfere with everyday functioning, medical decision making, and quality of life. Given that cognitive deficits develop with more frequency and intensity with increasing age, concerns mount that as people age with HIV, they may experience more severe cognitive deficits. These concerns become especially germane given that by 2015, 50% of those with HIV will be 50 and older, and this older cohort of adults is expected to grow. As such, this paper focuses on the etiologies of such cognitive deficits within the context of cognitive reserve and neuroplasticity. From this, evidence-based and hypothetical prevention (i.e., cognitive prescriptions), rehabilitation (i.e., speed of processing training), and mitigation (i.e., spaced retrieval method) strategies are reviewed. Implications for nursing practice and research are posited.
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