Aging induced loss of complexity and dedifferentiation: consequences for coordination dynamics within and between brain, muscular and behavioral levels

Force Fluctuations During Role-Differentiated Bimanual Movements Reflect Cognitive Impairments in Older Adults: A Cohort Sequential Study

During role-differentiated bimanual movements (RDBM), an object is typically stabilized with 1 hand and manipulated with the other. RDBM require coupling both hands for coordinated action (achieved through interhemispheric connections), but also inhibition of crosstalk to avoid involuntary movements in the stabilizing hand. We investigated how healthy cognitive aging and mild cognitive impairments (MCI) affect force stabilization during an RDBM in a cohort sequential study design with up to 4 measurement points over 32 months. In total, 132 older adults (>80 years) participated in this study, 77 were cognitively healthy individuals (CHI) and 55 presented with MCI. Participants performed a visuomotor bimanual force-tracking task. They either produced a constant force with both hands (bimanual constant) or a constant force with 1 and an alternating force with the other hand (role-differentiated). We investigated force fluctuations of constant force production using the coefficient of variation (CV), detrended fluctuation analysis (DFA), and sample entropy (SEn). Results showed higher CV and less complex variability structure (higher DFA and lower SEn) during the role-differentiated compared to the bimanual constant task. Furthermore, CHI displayed a more complex variability structure during the bimanual constant, but a less complex structure during the role-differentiated task than MCI. Interestingly, this complexity reduction was more pronounced in CHI than MCI individuals, suggesting different changes in the control mechanisms. Although understanding these changes requires further research, potential causes might be structural deteriorations leading to less efficient (intra- and interhemispheric) networks because of MCI, or an inability to appropriately divert the focus of attention.

Behavioural stochastic resonance across the lifespan

Stochastic resonance (SR) is the phenomenon wherein the introduction of a suitable level of noise enhances the detection of subthreshold signals in non linear systems. It manifests across various physical and biological systems, including the human brain. Psychophysical experiments have confirmed the behavioural impact of stochastic resonance on auditory, somatic, and visual perception. Aging renders the brain more susceptible to noise, possibly causing differences in the  SR phenomenon between young and elderly individuals. This study investigates the impact of noise on motion detection accuracy throughout the lifespan, with 214 participants ranging in age from 18 to 82. Our objective was to determine the optimal noise level to induce an SR-like response in both young and old populations. Consistent with existing literature, our findings reveal a diminishing advantage with age, indicating that the efficacy of noise addition progressively diminishes. Additionally, as individuals age, peak performance is achieved with lower levels of noise. This study provides the first insight into how SR changes across the lifespan of healthy adults and establishes a foundation for understanding the pathological alterations in perceptual processes associated with aging.

Spatial variability and directional shifts in postural control in Parkinson's disease

Individuals with Parkinson's disease exhibit tremors, rigidity, and bradykinesia, disrupting normal movement variability and resulting in postural instability. This comprehensive study aimed to investigate the link between the temporal structure of postural sway variability and Parkinsonism by analyzing multiple datasets from young and older adults, including individuals with Parkinson's disease, across various task conditions. We used the Oriented Fractal Scaling Component Analysis (OFSCA), which identifies minimal and maximal long-range correlations within the center of pressure time series, allowing for detecting directional changes in postural sway variability. The objective was to uncover the primary directions along which individuals exerted control during the posture. The results, as anticipated, revealed that healthy adults predominantly exerted control along two orthogonal directions, closely aligned with the anteroposterior (AP) and mediolateral (ML) axes. In stark contrast, older adults and individuals with Parkinson's disease exhibited control along suborthogonal directions that notably diverged from the AP and ML axes. While older adults and those with Parkinson's disease demonstrated a similar reduction in the angle between these two control directions compared to healthy older adults, their reliance on this suborthogonal angle concerning endogenous fractal correlations exhibited significant differences from the healthy aging cohort. Importantly, individuals with Parkinson's disease did not manifest the sensitivity to destabilizing task settings observed in their healthy counterparts, affirming the distinction between Parkinson's disease and healthy aging.

Towards Human-like Walking with Biomechanical and Neuromuscular Control Features: Personalized Attachment Point Optimization Method of Cable-Driven Exoskeleton

The cable-driven exoskeleton can avoid joint misalignment, and is substantial alterations in the pattern of muscle synergy coordination, which arouse more attention in recent years to facilitate exercise for older adults and improve their overall quality of life. This study leverages principles from neuroscience and biomechanical analysis to select attachment points for cable-driven soft exoskeletons. By extracting key features of human movement, the objective is to develop a subject-specific design methodology that provides precise and personalized support in the attachment points optimization of cable-driven exoskeleton to achieve natural gait, energy efficiency, and muscle coordination controllable in the domain of human mobility and rehabilitation. To achieve this, the study first analyzes human walking experimental data and extracts biomechanical features. These features are then used to generate trajectories, allowing better natural movement under complete cable-driven exoskeleton control. Next, a genetic algorithm-based method is employed to minimize energy consumption and optimize the attachment points of the cable-driven system. This process identifies connections that are better suited for the human model, leading to improved efficiency and natural movement. By comparing the calculated elderly human model driven by exoskeleton with experimental subject in terms of joint angles, joint torques and muscle forces, the human model can successfully replicate subject movement and the cable output forces can mimic human muscle coordination. The optimized cable attachment points facilitate more natural and efficient collaboration between humans and the exoskeleton, making significant contributions to the field of assisting the elderly in rehabilitation.

Approaching Process in Walking through an Aperture for Individuals with Stroke

Muroi et al. show that individuals with stroke have improved collision avoidance behavior when passing through an aperture while entering from the paretic-side of the body. However, the underlying mechanism remains unknown. We reanalyzed Muroi et al.'s data to reveal how individuals with stroke walk through an aperture by examining changes in walking velocity and behavioral complexity (i.e., sample entropy, an index of (ir)regularity of time series, regarded lower entropy as more regular and less complex) by focusing on the approaching process. The results showed that individuals with stroke reduced their walking velocity and behavioral complexity before passing through the narrow aperture when approaching from the paretic side. We interpreted that the improved obstacle avoidance when penetrating from the paretic side may be due to careful body rotation and adjusting the walking velocity in advance.

Heritability of cerebral blood flow in adolescent and young adult twins: an arterial spin labeling perfusion imaging study

Blood perfusion is a fundamental physiological property of all organs and is closely linked to brain metabolism. Genetic factors were reported to have important influences on cerebral blood flow. However, the profile of genetic contributions to cerebral blood flow in adolescents or young adults was underexplored. In this study, we recruited a sample of 65 pairs of same-sex adolescent or young adult twins undergoing resting arterial spin labeling imaging to conduct heritability analyses. Our findings indicate that genetic factors modestly affect cerebral blood flow in adolescents or young adults in the territories of left anterior cerebral artery and right posterior cerebral artery, with the primary contribution being to the frontal regions, cingulate gyrus, and striatum, suggesting a profile of genetic contributions to specific brain regions. Notably, the regions in the left hemisphere demonstrate the highest heritability in most regions examined. These results expand our knowledge of the genetic basis of cerebral blood flow in the developing brain and emphasize the importance of regional analysis in understanding the heritability of cerebral blood flow. Such insights may contribute to our understanding of the underlying genetic mechanism of brain functions and altered cerebral blood flow observed in youths with brain disorders.

Revisiting nonlinearity of heart rate variability in healthy aging

Aging is commonly regarded as a physiological process in which the dynamic complexity of physiological time series and organ systems is gradually lost. This notion is derived from the identification of a decline of nonlinear measures with the advance of aging. However, additional research on cardiovascular control studied through heart rate variability (HRV), i.e., the instantaneous changes in heart rate, shows that despite the constriction of its statistical distribution, the nonlinear organization remains present in advanced age. Here, we used surrogate data testing to investigate the presence of nonlinear information in HRV time series from a publicly available database of 1121 healthy human subjects from 18 to 92 years old. We also studied the influence of basic clinical features, such as sex, body mass index (BMI), and mean heart rate (HR), on such nonlinear information. We found that the percentage of nonlinear time series after 30 years of age diminishes significantly (p < 0.01). Furthermore, larger BMI and HR are associated with the presence of more linear information in HRV, while the female sex is associated with the manifestation of nonlinear information. This work provides a common background for the contextualized interpretation of nonlinear testing and shows that the nonlinear content of HRV time series diminishes through aging.

A GNN-based model for capturing spatio-temporal changes in locomotion behaviors of aging C. elegans

Investigating the locomotion of aging C. elegans is an important way for understanding the basic mechanisms behind age-related changes in organisms. However, the locomotion of aging C. elegans is often quantified using insufficient physical variables, which makes it challenging to capture essential dynamics. To study changes in the locomotion pattern of aging C. elegans, we developed a novel data-driven model based on graph neural networks, in which the C. elegans body is modeled as a long chain with interactions within and between adjacent segments, and their interactions are described by high-dimensional variables. Using this model, we discovered that each segment of the C. elegans body generally tends to maintain its locomotion, i.e., tries to keep the bending angle unchanged, and expects to change the locomotion of the adjacent segments. The ability to maintain its locomotion strengthens with age. Besides, a subtle distinguish in the changes in the locomotion pattern of C. elegans at various aging stages were observed. Our model is anticipated to provide a data-driven method for quantifying the changes in the locomotion pattern of aging C. elegans and for mining the underlying causes of these changes.

White-matter degradation and dynamical compensation support age-related functional alterations in human brain

Structural connectivity of the brain at different ages is analyzed using diffusion-weighted magnetic resonance imaging (MRI) data. The largest decrease of streamlines is found in frontal regions and for long inter-hemispheric links. The average length of the tracts also decreases, but the clustering is unaffected. From functional MRI we identify age-related changes of dynamic functional connectivity (dFC) and spatial covariation features of functional connectivity (FC) links captured by metaconnectivity. They indicate more stable dFC, but wider range and variance of MC, whereas static features of FC did not show any significant differences with age. We implement individual connectivity in whole-brain models and test several hypotheses for the mechanisms of operation among underlying neural system. We demonstrate that age-related functional fingerprints are only supported if the model accounts for: (i) compensation of the individual brains for the overall loss of structural connectivity and (ii) decrease of propagation velocity due to the loss of myelination. We also show that with these 2 conditions, it is sufficient to decompose the time-delays as bimodal distribution that only distinguishes between intra- and inter-hemispheric delays, and that the same working point also captures the static FC the best, and produces the largest variability at slow time-scales.

Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies

Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and sensory system. Meanwhile, some common treatment strategies, such as physical exercise, new equipment based on artificial intelligence, pharmacologic treatments and fall prevention education are also reviewed. To fully understand the pathogenesis and treatment of falls caused by balance disorders, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies.

Impact of Joint Fixation on Postural Dynamics during Single-Leg Stance

We investigated the relationship between the mechanical degrees of freedom (DoF) and its postural dynamics. The joint DoF was fixed to constrain the mechanical DoF. Nine participants were required to perform a single-leg stance task. The center of pressure trajectory data was analyzed. Ankle fixation induced a larger amount of variability in the anteroposterior direction, and less dimensionality and complexity in the mediolateral direction. These results suggest that the ankle joint fixation caused limited postural sway in the mediolateral direction; therefore, functional DoF and complexity decreased. In contrast, it increased the amount of postural sway variability in the anteroposterior direction. Our findings imply a direct relationship between the mechanical DoF of the human movement system and its postural dynamics.

Improving the effectiveness of anti-aging modalities by using the constrained disorder principle-based management algorithms

Aging is a complex biological process with multifactorial nature underlined by genetic, environmental, and social factors. In the present paper, we review several mechanisms of aging and the pre-clinically and clinically studied anti-aging therapies. Variability characterizes biological processes from the genome to cellular organelles, biochemical processes, and whole organs' function. Aging is associated with alterations in the degrees of variability and complexity of systems. The constrained disorder principle defines living organisms based on their inherent disorder within arbitrary boundaries and defines aging as having a lower variability or moving outside the boundaries of variability. We focus on associations between variability and hallmarks of aging and discuss the roles of disorder and variability of systems in the pathogenesis of aging. The paper presents the concept of implementing the constrained disease principle-based second-generation artificial intelligence systems for improving anti-aging modalities. The platform uses constrained noise to enhance systems' efficiency and slow the aging process. Described is the potential use of second-generation artificial intelligence systems in patients with chronic disease and its implications for the aged population.

Mediating effect of lower extremity muscle strength on the relationship between mobility and cognitive function in Chinese older adults: A cross-sectional study

Aging is a multifactorial process associated with irreversible decline in mobility and cognitive function. However, the mechanisms underlying the relationship between mobility and cognitive function remain elusive. In specific, the mediating effect of muscle strength, which is essential to maintain mobility, on this relationship has yet to be clarified. Accordingly, we performed a cross-sectional study involving Chinese older adults to understand the role of muscle strength in the relationship between mobility and cognitive function. The cognitive function and physical performance of 657 community-dwelling participants aged over 65 years old were observed. Cognitive function was assessed using the Mini-Mental State Examination, whereas physical performance, including mobility and muscle strength, was measured via Timed Up-and-Go Test and knee extension strength measurement. Data were statistically analyzed using PROCESS Model 4 developed by Hayes, and 595 complete data were finally included. Physical performance (mobility and muscle strength) was significantly correlated with cognitive function (p &lt; 0.01). Muscle strength was negatively correlated with mobility (r = −0.273, p &lt; 0.001) and positively correlated with cognitive function (r = 0.145, p &lt; 0.001). Muscle strength accounted for 20.1% of the total mediating effects on the relationship between mobility and cognitive function, which revealed the partial mediating role of lower extremity muscle strength in this relationship.

Blood pressure variability: a potential marker of aging

Aging is characterized by alterations in neuro-cardiovascular regulatory mechanisms, leading to impaired physiological variability patterns. Repeated evidence has shown that increased Blood Pressure Variability (BPV) is associated with organ damage and exerts independent predictive value on several health outcomes: cardiovascular events, neurocognitive impairment, metabolic disorders and typical geriatric syndromes such as sarcopenia and frailty. Accordingly, it may constitute the epiphenomenon of the alterations in homeostatic mechanisms, typical of late life. Aging and altered BPV share the same molecular mechanisms, in particular the clinical state of subclinical inflammation has been widely ascertained in advanced age and it is also related to BP dysregulation through altered endothelial function and increased production of ROS. Arterial stiffness and autonomic dysfunction have been associated to impairment in BPV and also represent key features in elderly patients. Furthermore, accumulating evidence in the field of Geroscience has reported that several molecular changes described in cardiovascular aging and altered BPV also relate with the majority of the 9 identified hallmarks of aging. Indeed, BPV may be linked to genomic instability, epigenetic modification and mitochondrial oxidative damage, which represent milestones of aging process. The aim of the present paper is to analyse the interplay between BPV and the pathophysiology of the ageing process, in order to stimulate discussion about the potential role of BPV as a new marker of aging.

Aberrant Cross-Tissue Functional Connectivity in Alzheimer’s Disease: Static, Dynamic, and Directional Properties

Background: BOLD signals in the gray matter (GM) and white matter (WM) are tightly coupled. However, our understanding of the cross-tissue functional network in Alzheimer’s disease (AD) is limited. Objective: We investigated the changes of cross-tissue functional connectivity (FC) metrics for the GM regions susceptible to AD damage. Methods: For each GM region in the default mode (DMN) and limbic networks, we obtained its low-order static FC with any WM region, and the high-order static FC between any two WM regions based on their FC pattern similarity with multiple GM regions. The dynamic and directional properties of cross-tissue FC were then acquired, specifically for the regional pairs whose low- or high-order static FCs showed significant differences between AD and normal control (NC). Moreover, these cross-tissue FC metrics were correlated with voxel-based GM volumes and MMSE in all participants. Results: Compared to NC, AD patients showed decreased low-order static FCs between the intra-hemispheric GM-WM pairs (right ITG-right fornix; left MoFG-left posterior corona radiata), and increased low-order static, dynamic, and directional FCs between the inter-hemispheric GM-WM pairs (right MTG-left superior/posterior corona radiata). The high-order static and directional FCs between the left cingulate bundle-left tapetum were increased in AD, based on their FCs with the GMs of DMN. Those decreased and increased cross-tissue FC metrics in AD had opposite correlations with memory-related GM volumes and MMSE (positive for the decreased and negative for the increased). Conclusion: Cross-tissue FC metrics showed opposite changes in AD, possibly as useful neuroimaging biomarkers to reflect neurodegenerative and compensatory mechanisms.

Rhythmic ability decline in aging individuals: The role of movement task complexity

Study aim: To investigate age-related changes in rhythmic reproduction ability in relation to the complexity of the adopted movement task.

Material and methods: A Stereophotogrammetric system was used to quantify individual rhythmic performances through motion analysis. Seventeen younger adult (age: 34.8 ± 4.2 yrs) and sixteen older adult (age: 69.9 ± 3.8 yrs) sedentary individuals volunteered for this study. Participants were administered a rhythmic test, which included three different rhythmic patterns to be reproduced by means of finger-tapping, foot-tapping and walking. Number of correct reproductions, time delays and rhythmic ratios were assessed and submitted to analysis of variance.

Results: For all rhythmic parameters, age-related differences emerged about rhythmic patterns and motor tasks. Older adults showed reduced accuracy as compared to their younger counterparts with a marked tendency to speed up beats reproduction (p < 0.05). Increased movement complexity negatively influenced rhythmic ability, with worst performances in the walking task (p < 0.05).

Conclusions: Complexity of the motor reproduction worsen rhythmic ability. Future research should focus on how specific rhythmic training with progressive movement task complexity could contrast this age-related decline.

GPCRs Are Optimal Regulators of Complex Biological Systems and Orchestrate the Interface between Health and Disease

GPCRs arguably represent the most effective current therapeutic targets for a plethora of diseases. GPCRs also possess a pivotal role in the regulation of the physiological balance between healthy and pathological conditions; thus, their importance in systems biology cannot be underestimated. The molecular diversity of GPCR signaling systems is likely to be closely associated with disease-associated changes in organismal tissue complexity and compartmentalization, thus enabling a nuanced GPCR-based capacity to interdict multiple disease pathomechanisms at a systemic level. GPCRs have been long considered as controllers of communication between tissues and cells. This communication involves the ligand-mediated control of cell surface receptors that then direct their stimuli to impact cell physiology. Given the tremendous success of GPCRs as therapeutic targets, considerable focus has been placed on the ability of these therapeutics to modulate diseases by acting at cell surface receptors. In the past decade, however, attention has focused upon how stable multiprotein GPCR superstructures, termed receptorsomes, both at the cell surface membrane and in the intracellular domain dictate and condition long-term GPCR activities associated with the regulation of protein expression patterns, cellular stress responses and DNA integrity management. The ability of these receptorsomes (often in the absence of typical cell surface ligands) to control complex cellular activities implicates them as key controllers of the functional balance between health and disease. A greater understanding of this function of GPCRs is likely to significantly augment our ability to further employ these proteins in a multitude of diseases.

Brain Networks Modulation in Young and Old Subjects During Transcranial Direct Current Stimulation Applied on Prefrontal and Parietal Cortex

Evidence indicates that the transcranial direct current stimulation (tDCS) has the potential to transiently modulate cognitive function, including age-related changes in brain performance. Only a small number of studies have explored the interaction between the stimulation sites on the scalp, task performance, and brain network connectivity within the frame of physiological aging. We aimed to evaluate the spread of brain activation in both young and older adults in response to anodal tDCS applied to two different scalp stimulation sites: Prefrontal cortex (PFC) and posterior parietal cortex (PPC). EEG data were recorded during tDCS stimulation and evaluated using the Small World (SW) index as a graph theory metric. Before and after tDCS, participants performed a behavioral task; a performance accuracy index was computed and correlated with the SW index. Results showed that the SW index increased during tDCS of the PPC compared to the PFC at higher EEG frequencies only in young participants. tDCS at the PPC site did not exert significant effects on the performance, while tDCS at the PFC site appeared to influence task reaction times in the same direction in both young and older participants. In conclusion, studies using tDCS to modulate functional connectivity and influence behavior can help identify suitable protocols for the aging brain.

A Dual-Task Paradigm Using the Oral Trail Making Test While Walking to Study Cognitive-Motor Interactions in Older Adults

Objective: With aging, gait becomes more dependent on executive functions, especially on switching abilities. Therefore, cognitive-motor dual-task (DT) paradigms should study the interferences between gait and switching tasks. This study aimed to test a DT paradigm based on a validated cognitive switching task to determine whether it could distinguish older-old adults (OO) from younger-old adults (YO).

Methods: Sixty-five healthy older participants divided into 29 younger-old (<70 years) and 36 older-old (≥70 years) age groups were evaluated in three single-task (ST) conditions as follows: a cognitive task including a processing speed component [Oral Trail Making Test part A (OTMT-A)], a cognitive task including a switching component [Oral Trail Making Test part B (OTMT-B)], and a gait evaluation at normal speed. They were also evaluated under two DT conditions, i.e., one associating gait with OTMT-A and the other associating gait with OTMT-B. Cognitive and gait performances were measured. The comparison of cognitive and gait performances between condition, logistic regression, and receiver operating characteristic (ROC) analyses were performed.

Results: The cognitive and gait performances were differently affected by the different conditions (i.e., ST, DT, OTMT-A, and OTMT-B). The OTMT-B produced higher interference on gait and cognitive performances. Moreover, a higher number of errors on the OTMT-B performed while walking was associated with the older-old age group.

Conclusion: Using validated cognitive flexibility tasks, this DT paradigm confirms the high interference between switching tasks and gait in older age. It is easily implemented, and its sensitivity to age may highlight its possible usefulness to detect cognitive or motor declines.

The Cognitive Connectome in Healthy Aging

Objectives: Cognitive aging has been extensively investigated using both univariate and multivariate analyses. Sophisticated multivariate approaches such as graph theory could potentially capture unknown complex associations between multiple cognitive variables. The aim of this study was to assess whether cognition is organized into a structure that could be called the “cognitive connectome,” and whether such connectome differs between age groups.

Methods: A total of 334 cognitively unimpaired individuals were stratified into early-middle-age (37–50 years, n = 110), late-middle-age (51–64 years, n = 106), and elderly (65–78 years, n = 118) groups. We built cognitive networks from 47 cognitive variables for each age group using graph theory and compared the groups using different global and nodal graph measures.

Results: We identified a cognitive connectome characterized by five modules: verbal memory, visual memory—visuospatial abilities, procedural memory, executive—premotor functions, and processing speed. The elderly group showed reduced transitivity and average strength as well as increased global efficiency compared with the early-middle-age group. The late-middle-age group showed reduced global and local efficiency and modularity compared with the early-middle-age group. Nodal analyses showed the important role of executive functions and processing speed in explaining the differences between age groups.

Conclusions: We identified a cognitive connectome that is rather stable during aging in cognitively healthy individuals, with the observed differences highlighting the important role of executive functions and processing speed. We translated the connectome concept from the neuroimaging field to cognitive data, demonstrating its potential to advance our understanding of the complexity of cognitive aging.

Cognitive Training Attenuates Decline in Physical Function Across 10 Years

OBJECTIVES

Poor physical function is associated with negative health and cognitive outcomes. Although nine studies demonstrated that cognitive training reduces age-related declines in physical function, only one study has examined the effects beyond immediate posttest changes. The first aim of this study was to assess the impact of three cognitive training programs on physical function measures across 10 years and the second aim was to examine whether baseline cognitive self-efficacy or depressive symptoms moderated training effects.

METHOD

Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial, older adults in a no-contact control condition (n = 698) were compared to those receiving processing speed (n = 702), memory (n = 703), or reasoning (n = 694) training. Intention-to-treat (ITT) and dosage analyses were conducted for grip strength and Turn 360. Participants were followed up to 10 years posttest.

RESULTS

There were no significant ITT effects of processing speed, memory, or reasoning training assignment to any physical function outcome (p > .05). Dosage models indicated that there were small age-related attenuation effects in Turn 360 decline with more processing speed training (b = -.011, p < .001), memory training (b = -.011, p < .001), and reasoning training (b = -.012, p < .001). There was no significant transfer to grip strength. These training gains were greater for those with more baseline depressive symptoms who received more processing speed training (b = -.001, p < .001).

DISCUSSION

This is the first study to demonstrate the effects of cognitive training to complex physical function across 10 years.

Promoting neuroplasticity and neuropsychological functioning in frailty through an app-based sensorimotor training: study protocol for a randomized trial

BACKGROUND

Frailty is characterized by an age-related decline in multiple physiological systems, leading to a high vulnerability to stressors, adverse health outcomes, and low quality of life. Neuroscientific models of pathological aging emphasize the loss of sensorimotor stimulation and reduced neuromodulatory capacities as core processes in age-related cognitive and bodily decline, which may be associated with maladaptive plastic changes in the brain. We plan to increase sensorimotor stimulation in frail persons through a newly developed app-based training program and link the training trials to biological and psychological correlates of age-associated vulnerability and health indices.

METHODS

We will conduct a randomized trial, applying an app-based sensorimotor home training (N = 30) in people suffering from frailty. An app-based relaxation training will serve as an active control condition (N = 30). Both interventions will last for 90 days each. The sensorimotor training includes unimodal and multimodal sensory discrimination tasks in the visual, auditory, and tactile domain, as well as sensorimotor precision tasks. The tasks will be implemented using an adaptive training algorithm and enriched with motivational components embedded in a virtual training environment. We expect a pre-post reduction of frailty status and associated functional decline related to refinement of representational maps within the sensorimotor system and improved sensorimotor function such as extremity function. Secondary analyses will study the influence of BDNF genotype as moderating variable. Additional outcomes will include measures of perceptual and cognitive functioning, quality of life as well as BDNF serum levels. Measurements will take place before training (baseline), after 60 days (assessment 1), and at the end of the training after 90 days (assessment 2).

DISCUSSION

In our randomized trial, we aim to characterize a multidimensional concept of frailty and to target maladaptive behaviors and neuroplasticity using an app-based sensorimotor training. This type of intervention might provide further knowledge and new possibilities for preventing decline and preserving function in older adults.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03666039 . Registered 11 September 2018 - Retrospectively registered. Protocol version: Version 4 revised (issue date: 19 May 2021).

Can Exergames Be Improved to Better Enhance Behavioral Adaptability in Older Adults? An Ecological Dynamics Perspective

Finding effective training solutions to attenuate the alterations of behavior and cognition in the growing number of older adults is an important challenge for Science and Society. By offering 3D computer-simulated environments to combine perceptual-motor and cognitive exercise, exergames are promising in this respect. However, a careful analysis of meta-analytic reviews suggests that they failed to be more effective than conventional motor-cognitive training. We analyzed the reasons for this situation, and we proposed new directions to design new, conceptually grounded, exergames. Consistent with the evolutionary neuroscience approach, we contend that new solutions should better combine high level of metabolic activity with (neuro)muscular, physical, perceptual-motor, and cognitive stimulations. According to the Ecological Dynamics rationale, we assume that new exergames should act at the agent-environment scale to allow individuals to explore, discover, and adapt to immersive and informationally rich environments that should include cognitively challenging tasks, while being representative of daily living situations.

Cortical Networks Underpinning Compensation of Verbal Fluency in Normal Aging

Elucidating compensatory mechanisms underpinning phonemic fluency (PF) may help to minimize its decline due to normal aging or neurodegenerative diseases. We investigated cortical brain networks potentially underpinning compensation of age-related differences in PF. Using graph theory, we constructed networks from measures of thickness for PF, semantic, and executive–visuospatial cortical networks. A total of 267 cognitively healthy individuals were divided into younger age (YA, 38–58 years) and older age (OA, 59–79 years) groups with low performance (LP) and high performance (HP) in PF: YA-LP, YA-HP, OA-LP, OA-HP. We found that the same pattern of reduced efficiency and increased transitivity was associated with both HP (compensation) and OA (aberrant network organization) in the PF and semantic cortical networks. When compared with the OA-LP group, the higher PF performance in the OA-HP group was associated with more segregated PF and semantic cortical networks, greater participation of frontal nodes, and stronger correlations within the PF cortical network. We conclude that more segregated cortical networks with strong involvement of frontal nodes seemed to allow older adults to maintain their high PF performance. Nodal analyses and measures of strength were helpful to disentangle compensation from the aberrant network organization associated with OA.

Human brain networks in physiological and pathological aging: reproducibility of EEG graph theoretical analysis in cortical connectivity

BACKGROUND

Physiological and pathological brain aging plays a central role in brain networks modulation. The aim of the present paper was to assess the stability of a proposed method for the evaluation of Small World (SW) characteristics for the study of Human Connectome.

METHODS

80 subjects were recruited: 36 young healthy controls, 32 elderly healthy controls, and 12 patients affected by Alzheimer's disease. Electroencephalograms (EEG) were recorded during six separate sessions (480 recordings) at an average inter-session interval of 3.8±0.2 days. Graph theory functions were applied to the undirected and weighted networks obtained by the lagged linear coherence evaluated by exact Low Resolution Electromagnetic Tomography (eLORETA). Were explored the following frequency bands: delta (2-4Hz), theta (4-8Hz), alpha1 (8-10.5Hz), alpha2 (10.5-13Hz), beta1 (13-20Hz), beta2 (20-30Hz) and gamma (30-40Hz).

RESULTS

The proposed method for the evaluation of Small World (SW) characteristics showed good reproducibility and stability. Furthermore, the results showed the pattern Young>Elderly>AD in low frequency delta and theta bands and vice versa in the higher alpha band. Finally, the correlation with age was confirmed in healthy subjects showing that older the age higher the SW values for alpha2.

DISCUSSION

Evidences from the present study confirm the stability of the Small World index and suggest that graph theory can support the analysis of connectivity patterns estimated from EEG. The proposed method for the evaluation of the characteristics of the Small World (SW) has shown good reproducibility and stability and applied to patient data, this technique could provide more information on the pathophysiological processes underlying the age-related brain disconnection, as well as on the administration of rehabilitation treatments at the right time that could allow to avoid unnecessary interventions.

Entropy modulation of electroencephalographic signals in physiological aging

Aging is a multifactorial physiological process characterized by the accumulation of degenerative processes impacting on different brain functions, including the cognitive one. A tool largely employed in the investigation of brain networks is the electroencephalogram (EEG). Given the cerebral complexity and dynamism, many non-linear approaches have been applied to explore age-related brain electrical activity modulation detected by the EEG: one of them is the entropy, which measures the disorder of a system. The present study had the aim to investigate aging influence on brain dynamics applying Approximate Entropy (ApEn) parameter to resting state EEG data of 68 healthy adult participants, divided with respect to their age in two groups, focusing on several specialized brain regions. Results showed that elderly participants present higher ApEn values than younger participants in the central, parietal and occipital areas, confirming the hypothesis that aging is characterized by an evolution of brain dynamics. Such findings may reflect a reduced synchronization of the neural networks cyclic activity, due to the reduction of cerebral connections typically found in aging process. Understanding the dynamics of brain networks by applying the entropy parameter could be useful for developing appropriate and personalized rehabilitation programs and for future studies on neurodegenerative diseases.

Physiological Resonance in Empathic Stress: Insights from Nonlinear Dynamics of Heart Rate Variability

Because most humans live and work in populated environments, researchers recently took into account that people may not only experience first-hand stress, but also second-hand stress related to the ability to empathically share another person’s stress response. Recently, researchers have begun to more closely examine the existence of such empathic stress and highlighted the human propensity to physiologically resonate with the stress responses of others. As in case of first-hand stress, empathic stress could be deleterious for health if people experience exacerbated activation of hypothalamic–pituitary–adrenal and autonomic nervous systems. Thus, exploring empathic stress in an observer watching someone else experiencing stress is critical to gain a better understanding of physiological resonance and conduct strategies for health prevention. In the current study, we investigated the influence of empathic stress responses on heart rate variability (HRV) with a specific focus on nonlinear dynamics. Classic and nonlinear markers of HRV time series were computed in both targets and observers during a modified Trier social stress test (TSST). We capitalized on multiscale entropy, a reliable marker of complexity for depicting neurovisceral interactions (brain-to-heart and heart-to-brain) and their role in physiological resonance. State anxiety and affect were evaluated as well. While classic markers of HRV were not impacted by empathic stress, we showed that the complexity marker reflected the existence of empathic stress in observers. More specifically, a linear model highlighted a physiological resonance phenomenon. We conclude on the relevance of entropy in HRV dynamics, as a marker of complexity in neurovisceral interactions reflecting physiological resonance in empathic stress.

Comparison of Three Physical-Cognitive Training Programs in Healthy Older Adults: A Study Protocol for a Monocentric Randomized Trial

(1) Combining aerobic, coordination and cognitive training allows for more improved physical and cognitive performance than when performed separately. A Nordic walking (NW) and two cognitive-motor circuit training programs (CT-c and CT-fit) are compared. CT-c and CT-fit stimulate cognition differently: CT-c, is through conventional complex coordination training performed in single and dual-task conditions; CT-fit, incorporates it into complex goal-directed actions, implemented by fitness gaming technology (2) The aim is to determine whether CT-fit brings additional benefits to cognition compared to more traditional training. (3) Forty-five healthy independent living community dwellers participants (65–80 years) will be included after a general medical examination. The main exclusion criteria are signs of cognitive impairments (Mini–Mental State Examination < 26/30) and physical impairments. Pre and post-tests will be performed to assess: cognitive functions (Montreal Cognitive Assessment; Trail Making Test; Stroop task, working memory test, Rey Complex Figure copy task, Oral Trail Making Test, and dual-task); motor fitness (Bipedal and unipedal balance test, gait assessments, Time Up and Go, chair sit and reach test and four-square stepping test); and physical fitness (10 m incremental shuttle walking test, maximal handgrip force, Timed-Stands test). (4) Incorporating cognitive demands into complex, goal-directed actions using fitness gaming technology should be the best solution to optimize training benefits.

Rehabilitation Concerns in the Geriatric Critically Ill and Injured - Part 1

Elderly patients who are critically ill have unique challenges that must be considered when attempting to prognosticate survival and determine expectations for physical rehabilitation and meaningful recovery. Furthermore, frail elderly patients present unique rehabilitation and clinical challenges when suffering from critical illness. There are multiple symptoms and syndromes that affect morbidity and mortality of elderly patients who require intensive care unit management including delirium, dementia, pain, and constipation. Rehabilitation goals should be based on patient values, clinical course, and functional status. Patients and families need accurate prognostic information to choose the appropriate level of care needed after critical illness.

Entropy and the Brain: An Overview

Entropy is a powerful tool for quantification of the brain function and its information processing capacity. This is evident in its broad domain of applications that range from functional interactivity between the brain regions to quantification of the state of consciousness. A number of previous reviews summarized the use of entropic measures in neuroscience. However, these studies either focused on the overall use of nonlinear analytical methodologies for quantification of the brain activity or their contents pertained to a particular area of neuroscientific research. The present study aims at complementing these previous reviews in two ways. First, by covering the literature that specifically makes use of entropy for studying the brain function. Second, by highlighting the three fields of research in which the use of entropy has yielded highly promising results: the (altered) state of consciousness, the ageing brain, and the quantification of the brain networks' information processing. In so doing, the present overview identifies that the use of entropic measures for the study of consciousness and its (altered) states led the field to substantially advance the previous findings. Moreover, it realizes that the use of these measures for the study of the ageing brain resulted in significant insights on various ways that the process of ageing may affect the dynamics and information processing capacity of the brain. It further reveals that their utilization for analysis of the brain regional interactivity formed a bridge between the previous two research areas, thereby providing further evidence in support of their results. It concludes by highlighting some potential considerations that may help future research to refine the use of entropic measures for the study of brain complexity and its function. The present study helps realize that (despite their seemingly differing lines of inquiry) the study of consciousness, the ageing brain, and the brain networks' information processing are highly interrelated. Specifically, it identifies that the complexity, as quantified by entropy, is a fundamental property of conscious experience, which also plays a vital role in the brain's capacity for adaptation and therefore whose loss by ageing constitutes a basis for diseases and disorders. Interestingly, these two perspectives neatly come together through the association of entropy and the brain capacity for information processing.

Stress Changes the Resting-State Cortical Flow of Information from Distributed to Frontally Directed Patterns

Despite converging evidence on the involvement of large-scale distributed brain networks in response to stress, the effect of stress on the components of these networks is less clear. Although some studies identify higher regional activities in response to stress, others observe an opposite effect in the similar regions. Studies based on synchronized activities and coactivation of these components also yield similar differing results. However, these differences are not necessarily contradictory once we observe the effect of stress on these functional networks in terms of the change in information processing capacity of their components. In the present study, we investigate the utility of such a shift in the analysis of the effect of stress on distributed cortical regions through quantification of the flow of information among them. For this purpose, we use the self-assessed responses of 216 individuals to stress-related questionnaires and systematically select 20 of them whose responses showed significantly higher and lower susceptibility to stress. We then use these 20 individuals' resting-state multi-channel electroencephalography (EEG) recordings (both Eyes-Closed (EC) and Eyes-Open (EO) settings) and compute the distributed flow of information among their cortical regions using transfer entropy (TE). The contribution of the present study is three-fold. First, it identifies that the stress-susceptibility is characterized by the change in flow of information in fronto-parietal brain network. Second, it shows that these regions are distributed bi-hemispherically and are sufficient to significantly differentiate between the individuals with high versus low stress-susceptibility. Third, it verifies that the high stress-susceptibility is markedly associated with a higher parietal-to-frontal flow of information. These results provide further evidence for the viewpoint in which the brain's modulation of information is not necessarily accompanied by the change in its regional activity. They further construe the effect of stress in terms of a disturbance that disrupts the flow of information among the brain's distributed cortical regions. These observations, in turn, suggest that some of the differences in the previous findings perhaps reflect different aspects of impaired distributed brain information processing in response to stress. From a broader perspective, these results posit the use of TE as a potential diagnostic/prognostic tool in identification of the effect of stress on distributed brain networks that are involved in stress-response.

Ankle control differentiation as a mechanism for mobility limitations

Independent control of the right and left ankles (differentiation) may be a motor control mechanism linking impaired coordination and mobility limitations. We tested the hypotheses that motor control differentiation of the ankles, as measured using Cross-Sample Entropy, during antiphase coordination at two movement frequencies, is associated with impaired coordination (high ankle coordination variability) and mobility limitations (Short Physical Performance Battery score ≤9). We conducted a cross-sectional study of community-dwelling older adults (N = 133) aged 80.04 (±4.67) years. In linear regression modeling, low ankle Cross-Sample Entropy (low motor control differentiation) was associated with poor (i.e., high) coordination variability at the slower (P = 0.026), but not the faster (P = 0.447), ankle movement frequency. In logistic regression modeling, low Cross-Sample Entropy at the slower (OR = 1.67; 95 % CI: 1.07-2.59) and faster (OR = 2.38; 95 % CI: 1.43-3.94) ankle movement frequencies were associated with increased odds for mobility limitations. Our findings support the hypothesis that ankle differentiation may be a motor control mechanism that links impaired coordination with mobility limitations.

Dynamic Functional Connectivity between order and randomness and its evolution across the human adult lifespan

Functional Connectivity (FC) during resting-state or task conditions is not static but inherently dynamic. Yet, there is no consensus on whether fluctuations in FC may resemble isolated transitions between discrete FC states rather than continuous changes. This quarrel hampers advancing the study of dynamic FC. This is unfortunate as the structure of fluctuations in FC can certainly provide more information about developmental changes, aging, and progression of pathologies. We merge the two perspectives and consider dynamic FC as an ongoing network reconfiguration, including a stochastic exploration of the space of possible steady FC states. The statistical properties of this random walk deviate both from a purely "order-driven" dynamics, in which the mean FC is preserved, and from a purely "randomness-driven" scenario, in which fluctuations of FC remain uncorrelated over time. Instead, dynamic FC has a complex structure endowed with long-range sequential correlations that give rise to transient slowing and acceleration epochs in the continuous flow of reconfiguration. Our analysis for fMRI data in healthy elderly revealed that dynamic FC tends to slow down and becomes less complex as well as more random with increasing age. These effects appear to be strongly associated with age-related changes in behavioural and cognitive performance.

Age-Varying Relationships Between Physical Function and Cognition in Older Adulthood

OBJECTIVES

There are positive relationships between physical and cognitive function in older adulthood; however, the strength of these relationships are inconsistent across studies. Although novel statistical tools provide flexibility to explore age-related differences in relationship magnitude, such methods have not been implemented in gerontological research. This study applied such methods to examine variations in relationship magnitude between physical function and cognition in healthy older adults (N = 2,783).

METHOD

Time-varying effects modeling (TVEM) is an extension of regression that models changes in relationships as a function of time-varying metrics like age. TVEM was used to examine if physical function (Turn 360, grip strength) predicted cognitive performance (memory, processing speed/attention, and reasoning) similarly across adults aged 65-90.

RESULTS

All associations between Turn 360 and all cognitive domains were significant and positive; however, speed of processing had significant magnitude variation across age such that the young-old and the old-old demonstrated the strongest relationships. Associations between grip strength and all cognitive domains significantly strengthened with increased age.

DISCUSSION

Results suggest that depending on the sample age, there may be inconsistencies in the relationships between physical and cognitive performance. Future research should explore these relationships longitudinally to better elucidate discrepant findings.

How Age, Cognitive Function and Gender Affect Bimanual Force Control

Coordinated bimanual control depends on information processing in different intra- and interhemispheric networks that differ with respect to task symmetry and laterality of execution. Aging and age-related cognitive impairments, but also sex can have detrimental effects on connectivity of these networks. We therefore expected effects of age, cognitive function and sex on bimanual force coordination. We furthermore expected these effects to depend on the characteristics of the task (i.e., difficulty and symmetry). 162 right handed participants (19 younger adults [YA], 21–30 years, 9 females; 52 cognitively healthy older adults [HOA], 80–91 years, 32 females; and 91 older adults with mild cognitive impairments [MCI] 80–91 years, 37 females) performed isometric bimanual force control tasks that required following constant or alternating (cyclic sine-wave) targets and varied in symmetry, i.e., (i) constant symmetric, asymmetric [with constant left and alternating right (ii) or vice versa (iii)], (iv) alternating in- and (v) alternating antiphase (both hands alternating with 0° or 180° relative phase, respectively). We analyzed general performance (time on target), bimanual coordination as coupling between hands (linear correlation coefficient) and structure of variability (i.e., complexity measured through detrended fluctuation analysis). Performance and coupling strongly depended on task symmetry and executing hand, with better performance in symmetric tasks and in asymmetric tasks when the left hand produced a constant and the right hand an alternating force. HOA and MCI, compared to YA, showed poorer performance (time on target) and reduced coupling in in- and antiphase tasks. Furthermore, both groups of OA displayed less complex structure in alternating force production tasks, a marker of reduced control. In addition, we found strong sex effects with females displaying reduced coupling during in- and antiphase coordination and less complex variably structure in constant force production. Results of this study revealed strong effects of age, but also sex on bimanual force control. Effects depended strongly on task symmetry and executing hand, possibly due to different requirements in interhemispheric information processing. So far, we found no clear relationship between behavioral markers of bimanual force control and age-related cognitive decline (compared to healthy aging), making further investigation necessary.

Contrasting Age Effects on Complexity of Tracking Force and Force Fluctuations During Monorhythmic Contraction

This study contrasted the stochastic force component between young and older adults, who performed pursuit tracking/compensatory tracking by exerting in-phase/antiphase forces to match a sinusoidal target. Tracking force was decomposed into the force component containing the target frequency and the nontarget force fluctuations (stochastic component). Older adults with inferior task performance had higher complexity (entropy across time; p = .005) in total force. For older adults, task errors were negatively correlated with force fluctuation complexity (pursuit tracking: r = -.527 to -.551; compensatory tracking: r = -.626 to -.750). Notwithstanding an age-related increase in total force complexity (p = .004), older adults exhibited lower complexity of the stochastic force component than young adults did (low frequency: p = .017; high frequency: p = .035). Those older adults with a higher complexity of stochastic force had better task performance due to the underlying use of a richer gradation strategy to compensate for impaired oscillatory control.

Asymmetry in the aging brain: A narrative review of cortical activation patterns and implications for motor function

Age-related changes have been identified in neural and motor level. A prominent change is reduced asymmetry in cortical activation as well as motor performance. Cortical activation models have been established based on cognitive research utilizing neuroimaging techniques to explain age-related effects on neural recruitment and reduced brain asymmetry. Recently, researchers in motor behaviour attempted to apply the models to explain motor pattern changes in aging and proposed compensation as the mechanism of the reduced motor asymmetry in older adults. Age-related alterations in movement patterns and brain activations seem to be correlated. However, based on the literature search result, no direct evidence substantiates the connection between reduced brain asymmetry and motor asymmetry in older adults. Therefore, a theoretical gap was identified. The theoretical gap exists because either neuroimaging studies have not considered motor asymmetry or motor asymmetry studies have not integrated neuroimaging techniques into study designs. Answering the research question can be valuable to both research and clinical practice. With the mechanisms of brain activation patterns during motor tasks in an aging population being better understood, protocols developed upon the new understandings can be applied to current motor interventions and better maintain the longevity of motor function of older adults.

Performance, complexity and dynamics of force maintenance and modulation in young and older adults

The present study addresses how task constraints and aging influence isometric force control. We used two tasks requiring either force maintenance (straight line target force) or force modulation (sine-wave target force) around different force levels and at different modulation frequencies. Force levels were defined relative the individual maximum voluntary contraction. A group of young adults (mean age ± SD = 25 ± 3.6 years) and a group of elderly (mean age = 77 ± 6.4 years) took part in the study. Age- and task-related effects were assessed through differences in: (i) force control accuracy, (ii) time-structure of force fluctuations, and (iii) the contribution of deterministic (predictable) and stochastic (noise-like) dynamic components to the expressed behavior. Performance-wise, the elderly showed a pervasive lower accuracy and higher variability than the young participants. The analysis of fluctuations showed that the elderly produced force signals that were less complex than those of the young adults during the maintenance task, but the reverse was observed in the modulation task. Behavioral complexity results suggest a reduced adaptability to task-constraints with advanced age. Regarding the dynamics, we found comparable generating mechanisms in both age groups for both tasks and in all conditions, namely a fixed-point for force maintenance and a limit-cycle for force modulation. However, aging increased the stochasticity (noise-driven fluctuations) of force fluctuations in the cyclic force modulation, which could be related to the increased complexity found in elderly for this same task. To our knowledge this is the first time that these different perspectives to motor control are used simultaneously to characterize force control capacities. Our findings show their complementarity in revealing distinct aspects of sensorimotor adaptation to task constraints and age-related declines. Although further research is still needed to identify the physiological underpinnings, the used task and methodology are shown to have both fundamental and clinical applications.

Effects of Nonstationarity on Muscle Force Signals Regularity During a Fatiguing Motor Task

Physiological signals present fluctuations that can be assessed from their temporal structure, also termed complexity. The complexity of a physiological signal is usually quantified using entropy estimators, such as Sample Entropy. Recent studies have shown a loss of force signal complexity with the development of neuromuscular fatigue. However, these studies did not consider the stationarity of the force signals which is an important prerequisite of Sample Entropy measurements. Here, we investigated the effect of the potential nonstationarity of force signals on the kinetics of neuromuscular fatigue-induced change in force signal's complexity. Eleven men performed submaximal intermittent isometric contractions of knee extensors until exhaustion. Neuromuscular fatigue was assessed from changes in voluntary and electrically evoked contractions. Sample Entropy values were computed from submaximal force signals throughout the fatiguing task. The Dickey-Fuller test was used to statistically investigate the stationarity of force signals and the Empirical Mode Decomposition was applied to detrend these signals. Maximal voluntary force, central voluntary activation and muscle twitch decreased throughout the task (all ), indicating the development of global, central and peripheral fatigue, respectively. We found an increase in Sample Entropy with fatigue ( p = 0.024 ) when not considering the nonstationarity of force signals (i.e., 43% of nonstationary signals). After applying the Empirical Mode Decomposition, we found a decrease in Sample Entropy with fatigue ( p = 0.002 ). These findings confirm the presence of nonstationarity in force signals during submaximal isometric contractions which influences the kinetics of Sample Entropy with neuromuscular fatigue.

Assessment of age-related decline of neurovascular coupling responses by functional near-infrared spectroscopy (fNIRS) in humans

Preclinical studies provide strong evidence that age-related impairment of neurovascular coupling (NVC) plays a causal role in the pathogenesis of vascular cognitive impairment (VCI). NVC is a critical homeostatic mechanism in the brain, responsible for adjustment of local cerebral blood flow to the energetic needs of the active neuronal tissue. Recent progress in geroscience has led to the identification of critical cellular and molecular mechanisms involved in neurovascular aging, identifying these pathways as targets for intervention. In order to translate the preclinical findings to humans, there is a need to assess NVC in geriatric patients as an endpoint in clinical studies. Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging technique that enables the investigation of local changes in cerebral blood flow, quantifying task-related changes in oxygenated and deoxygenated hemoglobin concentrations. In the present overview, the basic principles of fNIRS are introduced and the application of this technique to assess NVC in older adults with implications for the design of studies on the mechanistic underpinnings of VCI is discussed.

Self-initiated learning reveals memory performance and electrophysiological differences between younger, older and older adults with relative memory impairment

Older adults display difficulties in encoding and retrieval of information, resulting in poorer memory. This may be due to an inability of older adults to engage elaborative encoding strategies during learning. This study examined behavioural and electrophysiological effects of explicit cues to self-initiate learning during encoding and subsequent recognition of words in younger adults (YA), older control adults (OA) and older adults with relative memory impairment (OD). The task was a variation of the old/new paradigm, some study items were preceded by a cue to learn the word (L) while others by a do not learn cue (X). Behaviourally, YA outperformed OA and OD on the recognition task, with no significant difference between OA and OD. Event-related potentials at encoding revealed enhanced early visual processing (70-140 ms) for L- versus X-words in young and old. Only YA exhibited a greater late posterior positivity (LPP; 200-500 ms) for all words during encoding perhaps reflecting superior encoding strategy. During recognition, only YA differentiated L- versus X-words with enhanced frontal P200 (150-250 ms) suggesting impaired early word selection for retrieval in older groups; however, OD had enhanced P200 activity compared to OA during L-word retrieval. The LPP (250-500 ms) was reduced in amplitude for L-words compared to both X- and new words. However, YA showed greater LPP amplitude for all words compared to OA. For older groups, we observed reduced left parietal hemispheric asymmetry apparent in YA during encoding and recognition, especially for OD. Findings are interpreted in the light of models of compensation and dedifferentiation associated with age-related changes in memory function.

Cognitive frailty: A conceptual systematic review and an operational proposal for future research

OBJECTIVE

To analyze the definition of "cognitive frailty" and to study the conceptual and operational definitions used and their implications for empirical research. The relationships between this concept and cognitive reserve, the role of neuropathology and brain reserve, motor signs of aging and the reversibility of cognitive frailty are also discussed.

STUDY DESIGN

Systematic review of empirical studies identified from Medline Advanced 1966, CINAHL, Web of Science, PsycINFO, and Scopus until August 2017.

MAIN - OUTCOME MEASURES

Effect sizes. The quality of the articles was assessed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement. Three independent reviewers participated in the study selection and data extraction.

RESULTS

Nineteen studies involving 31,707 participants met the inclusion criteria. Significant associations were reported between cognitive frailty and physical frailty or gait speed. Screening instruments were usually used to determine objective cognitive decline rather than extensive neuropsychological assessments. Educational level was the only indicator of cognitive reserve that was systematically included in the evaluation of cognitive frailty. Motor decline and gait variables were not systematically included in protocols for the assessment of cognitive frailty.

CONCLUSIONS

A strong operational definition would benefit both the development of treatments to counter cognitive frailty and the assessment of treatment effectiveness. Nevertheless, since there is clear agreement regarding the importance of interventions for and the prevention of cognitive frailty, randomized controlled trials investigating the efficacy of preventive interventions are necessary.

Complexity Matching: Restoring the Complexity of Locomotion in Older People Through Arm-in-Arm Walking

The complexity matching effect refers to a maximization of information exchange, when interacting systems share similar complexities. Additionally, interacting systems tend to attune their complexities in order to enhance their coordination. This effect has been observed in a number of synchronization experiments, and interpreted as a transfer of multifractality between systems. Finally, it has been shown that when two systems of different complexity levels interact, this transfer of multifractality operates from the most complex system to the less complex, yielding an increase of complexity in the latter. This theoretical framework inspired the present experiment that tested the possible restoration of complexity in older people. In young and healthy participants, walking is known to present 1/f fluctuations, reflecting the complexity of the locomotion system, providing walkers with both stability and adaptability. In contrast walking tends to present a more disordered dynamics in older people, and this whitening was shown to correlate with fall propensity. We hypothesized that if an aged participant walked in close synchrony with a young companion, the complexity matching effect should result in the restoration of complexity in the former. Older participants were involved in a prolonged training program of synchronized walking, with a young experimenter. Synchronization within the dyads was dominated by complexity matching. We observed a restoration of complexity in participants after 3 weeks, and this effect was persistent 2 weeks after the end of the training session. This work presents the first demonstration of a restoration of complexity in deficient systems.

β-Arrestin Based Receptor Signaling Paradigms: Potential Therapeutic Targets for Complex Age-Related Disorders

G protein coupled receptors (GPCRs) were first characterized as signal transducers that elicit downstream effects through modulation of guanine (G) nucleotide-binding proteins. The pharmacotherapeutic exploitation of this signaling paradigm has created a drug-based field covering nearly 50% of the current pharmacopeia. Since the groundbreaking discoveries of the late 1990s to the present day, it is now clear however that GPCRs can also generate productive signaling cascades through the modulation of β-arrestin functionality. β-Arrestins were first thought to only regulate receptor desensitization and internalization - exemplified by the action of visual arrestin with respect to rhodopsin desensitization. Nearly 20 years ago, it was found that rather than controlling GPCR signal termination, productive β-arrestin dependent GPCR signaling paradigms were highly dependent on multi-protein complex formation and generated long-lasting cellular effects, in contrast to G protein signaling which is transient and functions through soluble second messenger systems. β-Arrestin signaling was then first shown to activate mitogen activated protein kinase signaling in a G protein-independent manner and eventually initiate protein transcription - thus controlling expression patterns of downstream proteins. While the possibility of developing β-arrestin biased or functionally selective ligands is now being investigated, no additional research has been performed on its possible contextual specificity in treating age-related disorders. The ability of β-arrestin-dependent signaling to control complex and multidimensional protein expression patterns makes this therapeutic strategy feasible, as treating complex age-related disorders will likely require therapeutics that can exert network-level efficacy profiles. It is our understanding that therapeutically targeting G protein-independent effectors such as β-arrestin will aid in the development of precision medicines with tailored efficacy profiles for disease/age-specific contextualities.

Do Complexity Measures of Frontal EEG Distinguish Loss of Consciousness in Geriatric Patients Under Anesthesia?

While geriatric patients have a high likelihood of requiring anesthesia, they carry an increased risk for adverse cognitive outcomes from its use. Previous work suggests this could be mitigated by better intraoperative monitoring using indexes defined by several processed electroencephalogram (EEG) measures. Unfortunately, inconsistencies between patients and anesthetic agents in current analysis techniques have limited the adoption of EEG as standard of care. In attempts to identify new analyses that discriminate clinically-relevant anesthesia timepoints, we tested 1/f frequency scaling as well as measures of complexity from nonlinear dynamics. Specifically, we tested whether analyses that characterize time-delayed embeddings, correlation dimension (CD), phase-space geometric analysis, and multiscale entropy (MSE) capture loss-of-consciousness changes in EEG activity. We performed these analyses on EEG activity collected from a traditionally hard-to-monitor patient population: geriatric patients on beta-adrenergic blockade who were anesthetized using a combination of fentanyl and propofol. We compared these analyses to traditional frequency-derived measures to test how well they discriminated EEG states before and after loss of response to verbal stimuli. We found spectral changes similar to those reported previously during loss of response. We also found significant changes in 1/f frequency scaling. Additionally, we found that our phase-space geometric characterization of time-delayed embeddings showed significant differences before and after loss of response, as did measures of MSE. Our results suggest that our new spectral and complexity measures are capable of capturing subtle differences in EEG activity with anesthesia administration-differences which future work may reveal to improve geriatric patient monitoring.

The relationship between gait dynamics and future cognitive decline: a prospective pilot study in geriatric patients

ABSTRACTBackground:Walking ability recently emerged as a sub-clinical marker of cognitive decline. Hence, the relationship between baseline gait and future cognitive decline was examined in geriatric patients. Because a "loss of complexity" (LOC) is a key phenomenon of the aging process that exhibits in multiple systems, we propose the idea that age- and cognition-related LOC may also become manifested in gait function. The LOC theory suggests that even healthy aging is associated with a (neuro)physiological breakdown of system elements that causes a decline in variability and an overall LOC. We used coordination dynamics as a conceptual framework and hypothesized that a LOC is reflected in dynamic gait outcomes (e.g. gait regularity, complexity, stability) and that such outcomes could increase the specificity of the gait-cognition link.

METHODS

19 geriatric patients (age 80.0±5.8) were followed for 14.4±6.6 months. An iPod collected three-dimensional (3D) trunk accelerations while patients walked for 3 minutes. Cognition was evaluated with the Mini-Mental State Examination (MMSE) and the Seven-Minute screen (7MS) test. The Reliable Change Index (RCI) quantified the magnitude of cognitive change. Spearman's Rho coefficients (ρ) indexed correlations between baseline gait and future cognitive change.

RESULTS

Seven patients showed reliable cognitive decline ("Cognitive Decline" group), and 12 patients remained cognitively stable ("Cognitive Stable" group) over time. Future cognitive decline was correlated with a more regular (ρ = 0.579*) and predictable (ρ = 0.486*) gait pattern, but not with gait speed.

CONCLUSIONS

The increase in gait regularity and predictability possibly reflects a LOC due to age- and cognition-related (neuro)physiological decline. Because dynamic versus traditional gait outcomes (i.e. gait speed and (variability of) stride time) were more strongly correlated with future cognitive decline, the use of wearable sensors in predicting and monitoring cognitive and physical health in vulnerable geriatric patients can be considered promising. However, our results are preliminary and do require replication in larger cohorts.

Impact of Healthy Aging on Multifractal Hemodynamic Fluctuations in the Human Prefrontal Cortex

Fluctuations in resting-state cerebral hemodynamics show scale-free behavior over two distinct scaling ranges. Changes in such bimodal (multi) fractal pattern give insight to altered cerebrovascular or neural function. Our main goal was to assess the distribution of local scale-free properties characterizing cerebral hemodynamics and to disentangle the influence of aging on these multifractal parameters. To this end, we obtained extended resting-state records (N = 2¹⁴) of oxyhemoglobin (HbO), deoxyhemoglobin (HbR) and total hemoglobin (HbT) concentration time series with continuous-wave near-infrared spectroscopy technology from the brain cortex. 52 healthy volunteers were enrolled in this study: 24 young (30.6 ± 8.2 years), and 28 elderly (60.5 ± 12.0 years) subjects. Using screening tests on power-law, multifractal noise, and shuffled data sets we evaluated the presence of true multifractal hemodynamics reflecting long-range correlation (LRC). Subsequently, scaling-range adaptive bimodal signal summation conversion (SSC) was performed based on standard deviation (σ) of signal windows across a range of temporal scales (s). Building on moments of different order (q) of the measure, σ(s), multifractal SSC yielded generalized Hurst exponent function, H(q), and singularity spectrum, D(h) separately for a fast and slow component (the latter dominating the highest temporal scales). Parameters were calculated reflecting the estimated measure at s = N (focus), degree of LRC [Hurst exponent, H(2) and maximal Hölder exponent, h_max] and measuring strength of multifractality [full-width-half-maximum of D(h) and ΔH₁₅ = H(−15)−H(15)]. Correlation-based signal improvement (CBSI) enhanced our signal in terms of interpreting changes due to neural activity or local/systemic hemodynamic influences. We characterized the HbO-HbR relationship with the aid of fractal scale-wise correlation coefficient, r_σ(s) and SSC-based multifractal covariance analysis. In the majority of subjects, cerebral hemodynamic fluctuations proved bimodal multifractal. In case of slow component of raw HbT, h_max, and Ĥ(2) were lower in the young group explained by a significantly increased r_σ(s) among elderly at high temporal scales. Regarding the fast component of CBSI-pretreated HbT and that of HbO-HbR covariance, h_max, and focus were decreased in the elderly group. These observations suggest an attenuation of neurovascular coupling reflected by a decreased autocorrelation of the neuronal component concomitant with an accompanying increased autocorrelation of the non-neuronal component in the elderly group.

Concurrent Changes of Brain Functional Connectivity and Motor Variability When Adapting to Task Constraints

In behavioral neuroscience, the adaptability of humans facing different constraints has been addressed on one side at the brain level, where a variety of functional networks dynamically support the same performance, and on the other side at the behavioral level, where fractal properties in sensorimotor variables have been considered as a hallmark of adaptability. To bridge the gap between the two levels of observation, we have jointly investigated the changes of network connectivity in the sensorimotor cortex assessed by modularity analysis and the properties of motor variability assessed by multifractal analysis during a prolonged tapping task. Four groups of participants had to produce the same tapping performance while being deprived from 0, 1, 2, or 3 sensory feedbacks simultaneously (auditory and/or visual and/or tactile). Whereas tapping performance was not statistically different across groups, the number of brain networks involved and the degree of multifractality of the inter-tap interval series were significantly correlated, increasing as a function of feedback deprivation. Our findings provide first evidence that concomitant changes in brain modularity and multifractal properties characterize adaptations underlying unchanged performance. We discuss implications of our findings with respect to the degeneracy properties of complex systems, and the entanglement of adaptability and effective adaptation.