Assessing Visuospatial Abilities in Healthy Aging: A Novel Visuomotor Task

Impact of repetitive home-based galvanic vestibular stimulation on cognitive skills in healthy older adults

The human vestibular system is adversely affected by the aging process. Recent evidence indicates that vestibular information and cognitive functions are related, suggesting that age-related vestibular loss may contribute to cognitive impairment. In this study, we aimed to investigate the effects of repetitive, home-based galvanic vestibular stimulation (GVS) on cognitive functions in healthy older adults. Twenty-one participants (age = 64.66 ± 2.97 years, 12 females) were randomly allocated to either a home-based GVS or an active control group. The GVS intervention lasted 20 min per session, five times a week, for two weeks (10 sessions). Cognitive functions were assessed before and after the intervention using the Stroop Test, Trail Making Test A&B, and Dual-Task (digit recall and paper-pencil tracking test). Our findings revealed a significant group-by-time interaction effect for the tracking accuracy (F(1,18) = 7.713, p = 0.012, η p2 = 0.30), with only the home-based GVS group showing significant improvement (t = -2.544, p = 0.029). The proposed home-based GVS protocol offers a promising non-pharmacological avenue for enhancing visuospatial ability in healthy older adults. Further research is needed to investigate the effects of different GVS protocols on various cognitive functions, particularly in older individuals with different health conditions.

Cognitive status is associated with performance of manual wheelchair skills in hospitalized older adults

PURPOSE

To examine the relationship between manual wheelchair skills and cognitive function in hospitalized older adults.

METHODS

The observational study included older adults who used a manual wheelchair following hip/knee surgery. Participants underwent a series of tests to evaluate manual wheelchair skills and cognitive performance. Four items appearing on the Wheelchair Skills Test: brake handling (locking/unlocking), a 10-metre forward roll, a 2-metre backward roll and rotating in place, were used to evaluate manual wheelchair skills. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), the Clock Drawing Test, and the Loewenstein Occupational Therapy Cognitive Assessment. The relationship between wheelchair skills and cognitive scores was assessed by a series of univariate linear regression analyses.

RESULTS

Fifty older adults, aged 65-85, participated in the study. The MoCA-7 (orientation) explained 19.3% of the variance related to the turn in place wheelchair skill, 18.8% of the variance related to the two-metre backwards roll and 31.9% of the variance related to the 10-metre forward roll. The addition of gender (to the MoCA-7) increased the explained variance related to the 10-metre forward roll and turn in place skills to 38.5% and 28.5%, respectively. As for the brakes handling skill test, gender explained 18.3% of the variance. The addition of the CDT (to gender) increased the explained variance for the brakes handling skill to 31.4%.

CONCLUSIONS

Because cognitive impairments negatively affect the performance of wheelchair skills, rehabilitation therapists may need to adjust wheelchair mobility training methods for cognitively impaired older adults.Implication for rehabilitationGiven the prevalence of older adults with cognitive impairments who use manual wheelchairs, it is critical to better understand the relationship between cognition and wheelchair skills.Poor results reported on the cognitive tests, specifically, visual attention and orientation, were found to be associated with poor performance of four manual wheelchair skills.Rehabilitation therapists should consider the cognitive status of older adults when teaching manual wheelchair skills, specifically in new users. Future studies should examine whether a customized preparation program, enhancing visuospatial orientation, can benefit manual wheelchair control in older adults.

Brain volumetric changes in menopausal women and its association with cognitive function: a structured review

The menopausal transition has been proposed to put women at risk for undesirable neurological symptoms, including cognitive decline. Previous studies suggest that alterations in the hormonal milieu modulate brain structures associated with cognitive function. This structured review provides an overview of the relevant studies that have utilized MRI to report volumetric differences in the brain following menopause, and its correlations with the evaluated cognitive functions. We performed an electronic literature search using Medline (Ovid) and Scopus to identify studies that assessed the influence of menopause on brain structure with MRI. Fourteen studies met the inclusion criteria. Brain volumetric differences have been reported most frequently in the frontal and temporal cortices as well as the hippocampus. These regions are important for higher cognitive tasks and memory. Additionally, the deficit in verbal and visuospatial memory in postmenopausal women has been associated with smaller regional brain volumes. Nevertheless, the limited number of eligible studies and cross-sectional study designs warrant further research to draw more robust conclusions.

Don't disturb my circles: The effect of fine arts training on visuospatial ability in students

Origami, drawing and colouring are artistic activities that can be beneficial for cognitive abilities or emotional well-being. However, there is a lack of studies that would investigate and compare these activities and their effects within the spatial abilities' domain. The aim of this study was to investigate if and how participating in three artistic activities-colouring, drawing or origami-can enhance spatial abilities. A total of 73 young adults participated in one of the three activities organized as a 7-session training, distributed every third day. Measures of spatial abilities (Spatial Reconstruction Task [SRT]), Mental Rotation Task [MRT]), Santa Barbara Solids Task [SBST]), and Corsi Block Tapping Task [Corsi]) were administered before (pretest) and after (posttest) the training, as well as at the 6-month follow-up). The Intrinsic Motivation Inventory (IMI) was administered at the posttest. The results showed no significant interaction between the training group and the measurement time point for the spatial ability tasks. Nevertheless, effect sizes at posttest favor origami and drawing in enhancing more complex spatial abilities (MRT for origami and drawing; SBST for origami; Corsi for drawing), and colouring in strengthening spatial perception (SRT). Some effects have remained for a longer period of time. Origami led to a greater pressure and tension, and colouring to higher interest and enjoyment. These results suggest that artistic activities can potentially contribute to the strengthening of spatial abilities, but it is advised to presented them in a way that reduces frustration and increase participant's enjoyment.

Mean amplitude of low frequency fluctuations measured by fMRI at 11.7 T in the aging brain of mouse lemur primate

Non-human primates are a critical species for the identification of key biological mechanisms in normal and pathological aging. One of these primates, the mouse lemur, has been widely studied as a model of cerebral aging or Alzheimer's disease. The amplitude of low-frequency fluctuations of blood oxygenation level-dependent (BOLD) can be measured with functional MRI. Within specific frequency bands (e.g. the 0.01-0.1 Hz), these amplitudes were proposed to indirectly reflect neuronal activity as well as glucose metabolism. Here, we first created whole brain maps of the mean amplitude of low frequency fluctuations (mALFF) in young mouse lemurs (mean ± SD: 2.1 ± 0.8 years). Then, we extracted mALFF in old lemurs (mean ± SD: 8.8 ± 1.1 years) to identify age-related changes. A high level of mALFF was detected in the temporal cortex (Brodmann area 20), somatosensory areas (Brodmann area 5), insula (Brodmann areas 13-6) and the parietal cortex (Brodmann area 7) of healthy young mouse lemurs. Aging was associated with alterations of mALFF in somatosensory areas (Brodmann area 5) and the parietal cortex (Brodmann area 7).

Normal aging in mice is associated with a global reduction in cortical spectral power and network-specific declines in functional connectivity

Normal aging is associated with a variety of neurologic changes including declines in cognition, memory, and motor activity. These declines correlate with neuronal changes in synaptic structure and function. Degradation of brain network activity and connectivity represents a likely mediator of age-related functional deterioration resulting from these neuronal changes. Human studies have demonstrated both general decreases in spontaneous cortical activity and disruption of cortical networks with aging. Current techniques used to study cerebral network activity are hampered either by limited spatial resolution (e.g. electroencephalography, EEG) or limited temporal resolution (e.g., functional magnetic resonance imaging, fMRI). Here we utilize mesoscale imaging of neuronal activity in Thy1-GCaMP6f mice to characterize neuronal network changes in aging with high spatial resolution across a wide frequency range. We show that while evoked activity is unchanged with aging, spontaneous neuronal activity decreases across a wide frequency range (0.01–4 Hz) involving all regions of the cortex. In contrast to this global reduction in cortical power, we found that aging is associated with functional connectivity (FC) deterioration of select networks including somatomotor, cingulate, and retrosplenial nodes. These changes are corroborated by reductions in homotopic FC and node degree within somatomotor and visual cortices. Finally, we found that whole-cortex delta power and delta band node degree correlate with exploratory activity in young but not aged animals. Together these data suggest that aging is associated with global declines in spontaneous cortical activity and focal deterioration of network connectivity, and that these reductions may be associated with age-related behavioral declines.

The Contribution of Shape Features and Demographic Variables to Disembedding Abilities

Humans naturally perceive visual patterns in a global manner and are remarkably capable of extracting object shapes based on properties such as proximity, closure, symmetry, and good continuation. Notwithstanding the role of these properties in perceptual grouping, studies highlighted differences in disembedding performance across individuals, which are summarized by the field dependence dimension. Evidence suggests that age and educational attainment explain part of this variability, whereas the role of sex is still highly debated. Also, which stimulus features primarily influence inter-individual variations in perceptual grouping has still to be fully determined. Building upon these premises, we assessed the role of age, education level, and sex on performance at the Leuven Embedded Figure Test—a proxy of disembedding abilities—in 391 cisgender individuals. We also investigated to what extent shape symmetry, closure, complexity, and continuation relate to task accuracy. Overall, target asymmetry, closure, and good continuation with the embedding context increase task difficulty. Simpler shapes are more difficult to detect than those with more lines, yet context complexity impairs the recognition of complex targets (i.e., those with 6 lines or more) to a greater extent. Concerning demographic data, we confirm that age and educational attainment are significantly associated with disembedding abilities and reveal a perceptual advantage in males. In summary, our study further highlights the role of shape properties in disembedding performance and unveils sex differences not reported so far.

Sleep Polygenic Risk Score Is Associated with Cognitive Changes over Time

Sleep problems have been associated with cognition, both cross-sectionally and longitudinally. Specific genes have been also associated with both sleep regulation and cognition. In a large group of older non-demented adults, we aimed to (a) validate the association between Sleep Polygenic Risk Score (Sleep PRS) and self-reported sleep duration, and (b) examine the association between Sleep PRS and cognitive changes in a three-year follow-up. Participants were drawn from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). A structured, in-person interview, consisting of a medical history report and physical examination, was conducted for each participant during each of the visits (baseline and first follow-up). In total, 1376 participants were included, having all demographic, genetic, and cognitive data, out of which, 688 had at least one follow-up visit. In addition, an extensive neuropsychological assessment examining five cognitive domains (memory, visuo-spatial ability, attention/speed of processing, executive function, and language) was administered. A PRS for sleep duration was created based on previously published, genome-wide association study meta-analysis results. In order to assess the relationship between the Sleep PRS and the rate of cognitive change, we used generalized estimating equations analyses. Age, sex, education, ApolipoproteinE-ε4 genotype status, and specific principal components were used as covariates. On a further analysis, sleep medication was used as a further covariate. Results validated the association between Sleep PRS and self-reported sleep duration (B = 1.173, E-6, p = 0.001). Further, in the longitudinal analyses, significant associations were indicated between increased Sleep PRS and decreased visuo-spatial ability trajectories, in both the unadjusted (B = -1305.220, p = 0.018) and the adjusted for the covariates model (B = -1273.59, p = 0.031). Similarly, after adding sleep medication as a covariate (B = -1372.46, p = 0.019), none of the associations between Sleep PRS and the remaining cognitive domains were significant. PRS indicating longer sleep duration was associated with differential rates of cognitive decline over time in a group of non-demented older adults. Common genetic variants may influence the association between sleep duration and healthy aging/cognitive health.

One brick at a time: Building a developmental profile of spatial abilities

Spatial abilities are not only fundamental for activities of daily living, but they are also markers of academic and professional success. It has remained a challenge, however, to understand their development across childhood and adolescence, partly because of the lack of spatial tasks that are appropriate across age groups. For example, the well-established paper-based mental rotation test (MRT) has been shown to be too difficult for children. In the current study, we tested girls and boys in three age groups: younger children (5-8-years-old), older children (9-12), and adolescents (13-17) on a hands-on visuospatial task using toy bricks: the brick-building task (BBT). Children completed a low- and a high-mental rotation demand (LMR and HMR) version of the BBT and the paper-based MRT. Correlations were found between all tasks. Children, especially females, found the HMR more challenging than the LMR condition, but all children successfully completed the BBT. In contrast, the MRT was too difficult for the younger children to solve performing at chance. Given this result and that the BBT is a game-like, 3D, interactive task, the BBT could be used to examine the biological and/or environmental factors that affect the early development of visuospatial abilities.

An evaluation of visuospatial skills using hands-on tasks

Several tests of mental rotation ability have been used to investigate its development and the origins of sex differences. One of the most used tests is the mental rotation test (MRT) by Vandenberg and Kuse. A limitation of the MRT is that it is a pen-and-paper test with 2D images of 3D objects. This is a challenge to the ecological validity of the MRT because mental rotation typically involves physical 3D objects that are also physically manipulated. The purpose of the present study was to compare mental rotation ability as evaluated by the MRT to three new tasks with physical objects (toy bricks) that were physically manipulated. The different tasks allowed us to vary the processing demands on mental rotation while standardizing other aspects of the tasks. Fifty-nine females and twenty-eight males completed the LMR and HMR conditions (low- and high-mental rotation demands, respectively) of the brick building task (BBT), a visual search task, and the MRT. As demands on mental rotation for the BBT increased, performance decreased and a sex difference, with males outperforming females, increased. There were correlations between all tasks, but they were larger between the versions of the BBT with the MRT. The results suggest that spatial skill is an assembly of interrelated subskills and that the sex difference is sensitive to the demands on mental rotation and dimensionality crossing. The benefits of the BBT are that it is ecologically valid, avoids dimensionality crossing, and the demands on mental rotation can be manipulated.

Healthy Aging and Dementia: Two Roads Diverging in Midlife?

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

Proposal for a hierarchical, multidimensional, and multivariate approach to investigate cognitive aging

Cognitive aging is highly complex. We applied a data-driven statistical method to investigate aging from a hierarchical, multidimensional, and multivariate approach. Orthogonal partial least squares to latent structures and hierarchical models were applied for the first time in a study of cognitive aging. The association between age and a total of 316 demographic, clinical, cognitive, and neuroimaging measures was simultaneously analyzed in 460 cognitively normal individuals (35-85 years). Age showed a strong association with brain structure, especially with cortical thickness in frontal and parietal association regions. Age also showed a fairly strong association with cognition. Although a strong association of age with executive functions and processing speed was captured as expected, the association of age with visual memory was stronger. Clinical measures were less strongly associated with age. Hierarchical and correlation analyses further showed these associations in a neuroimaging-cognitive-clinical order of importance. We conclude that orthogonal partial least square and hierarchical models are a promising approach to better understand the complexity in cognitive aging.

Expectation of movement generates contrasting changes in multifinger synergies in young and older adults

Anticipatory synergy adjustment (ASA) is a feed-forward control mechanism that describes a continuous decrease in the stability of the current motor state beginning about 150 ms prior to a state transition. Recently, we described an associated phenomenon in which the system stability was reduced solely in response to a cue that generates an expectation of a state change, independent of whether the state change actually occurs. Both phenomena are of the same kind (stability reduction), but evoked by distinct antecedent conditions. Since, logically, cuing for movement must occur before the initiation of that movement, we named this new phenomenon 'Stage-1 ASA' and rechristened the well-established version 'Stage-2 ASA'. Here, we used a four-finger, isometric force production task to explore (1) the effect of healthy aging on Stage-1 ASA, and (2) if Stage-1 ASA resulted in a more rapid state change. Young and older adult participants produced 10% of their maximal force when they did not expect to produce any change in the force, and when they expected to change their force in an unknown direction and at an unknown time. In the latter condition, the 10% constant-force phase was followed by a choice reaction time task, in which the participants rapidly changed their force to follow a moving target presented on a computer monitor. Both young and older adults displayed equivalent amount of Stage-1 ASA. This was driven by a 42% reduction in finger-force variability in young adults. In contrast, it was driven by a 38% increase in finger-force variability in older adults. We speculate that the reduction in finger force variability assists the young adults in rapid state changes via two mechanisms: (1) the finger forces occupy a restricted set of states that are optimal for quick state transitions, and (2) lower variability during steady state translates into lower self-motion during state transition. Self-motion is the covariation between finger forces that fails to change the total force. The older adults are unable to adopt this strategy, and the increase in finger-force variability arises from (1) the adoption of an alternative strategy of destabilizing the attractor associated with the current state to facilitate state transitions and (2) the inability to coordinate multiple finger forces. Finally, older adults displayed longer reaction times than young adults, but a clear relation between Stage-1 ASA and consequent behavioral benefit in terms of reduced reaction time remained elusive.

Sensorimotor lateralization scaffolds cognitive specialization

In this chapter, we review hemispheric differences for sensorimotor function and cognitive abilities. Specifically, we examine the left-hemisphere specialization for visuomotor control and its interplay with language, executive function, and musical training. Similarly, we discuss right-hemisphere lateralization for haptic processing and its relationship to spatial and numerical processing. We propose that cerebral lateralization for sensorimotor functions served as a foundation for the development of higher cognitive abilities and their hemispheric functional specialization. We further suggest that sensorimotor and cognitive functions are inextricably linked. Based on the studies discussed in this chapter our view is that sensorimotor control serves as a loom upon which the fibers of language, executive function, spatial, and numerical processing are woven together to create the fabric of cognition.

The effects of age and sex on hand movement structure

The aim was to investigate the effects of age and sex on hand function and ascertain age-related changes (magnitude and rate) by assessing a broad range of functional tasks with the dominant and non-dominant hands. A representative sample of 635 adults (114 males and 491 females) aged 50 years and over completed motor performance series of the Vienna Test System Parametric and non-parametric analysis and simple linear regression was used to examine the relationships. Significant relationships were observed between task performance and age and sex, although the contributions of both factors differed by varying degree. Compared with males, the females performed significantly better than males in the majority of tests, particularly with the dominant hand, although greater age-related reductions were observed in performance. Among the skills quantifying hand function, age accounted for the most variance in hand and finger dexterity.

Age-related changes in hand dominance and functional asymmetry in older adults

The aim of the study was to investigate fine motor performance and ascertain age-related changes in laterality between the dominant and non-dominant hand. A representative sample of 635 adults (144 males and 491 females) aged 50 years and over completed a test battery MLS (Motor Performance Series) to assess a broad range of hand functions. Functional asymmetry was observed in all four motor tests (postural tremor, aiming, tapping, and inserting long pins). Significant differences between the dominant and non-dominant hand were obtained in both sexes across all age groups, except in the oldest female group (age >70) for the aiming (number of hits and errors) and postural tremor (number of errors) tasks. These differences in age-related changes may be attributed to hemispheric asymmetry, environmental factors, or use-dependent plasticity. Conflicting evidence in the literature warrants additional research to better explain age-related alterations of hand dominance and manual performance in old age.