Vera Schumacher

The Interplay between Cognitive and Motor Functioning in Healthy Older Adults: Findings from Dual-Task Studies and Suggestions for Intervention

Reaching late adulthood is accompanied by losses in physical and mental resources, but lifestyle choices seem to have a considerable influence on the aging trajectory. This review deals with the interplay between cognitive and motor functioning in old age, focusing on two different lines of research, namely (a) dual-task studies requiring participants to perform a cognitive and a motor task simultaneously, and (b) intervention studies investigating whether increases in physical fitness also lead to improvements in cognitive performance. Dual-task studies indicate that healthy older adults show greater performance reductions in both domains than young adults when performing a cognitive and a motor task simultaneously. In addition, older adults often tend to protect their motor functioning at the expense of the cognitive task when the situation involves a threat to balance. This can be considered an adaptive behavior since fall-related injuries can have severe consequences. Fitness intervention studies which increased the aerobic fitness of previously sedentary older adults have demonstrated impressive performance improvements in the cognitive domain, especially for tasks involving executive control processes. These findings are interesting in light of cognitive intervention studies, which often fail to find significant transfer effects to tasks that have not been trained directly. The authors argue that future research should compare the effects of cognitive and aerobic fitness interventions in older adults, and they present a study design in which cognition and fitness are trained sequentially as well as simultaneously. Finally, methodological issues involved in this type of research and potential applications to applied settings are discussed.

Simultaneously Measuring Gait and Cognitive Performance in Cognitively Healthy and Cognitively Impaired Older Adults: The Basel Motor-Cognition Dual-Task Paradigm

OBJECTIVES: To investigate dual‐task performance of gait and cognition in cognitively healthy and cognitively impaired older adults using a motor–cognition dual‐task paradigm.

Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up

Background Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive–physical components would add training specific cognitive benefits compared to exclusively physical training. Methods Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Results Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive–physical programs were found in two dimensions of executive function. “Shifting attention” showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and “working memory” showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R2=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Conclusion Particular executive functions benefit from simultaneous cognitive–physical training compared to exclusively physical multicomponent training. Cognitive–physical training programs may counteract widespread cognitive impairments in the elderly.

Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up.

Background About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive–physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. Methods Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. Results Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (−77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or trend). Conclusion Long-term multicomponent cognitive–physical and exclusive physical training programs demonstrated similar potential to counteract age-related decline in physical functioning.

One IMU is sufficient: A study evaluating effects of dual-tasks on gait in elderly people

In industrialized countries the share of elderly subjects is increasing. Hence, diseases or symptoms associated with aging are more common than they were in the past. As a consequence, more effort is invested into research analyzing the effects of aging on the motion and cognition. However, economical and flexible methods to measure motion and its cross-effects with cognition are still missing. Therefore, we developed a new approach which neither requires a specific location, large infrastructural requirements, nor does it require large investments. We base our setting on match-box sized inertial measurement units (IMUs) attached to the participants’ legs. 47 elderly subjects participated in our study where we analyzed the interplay between cognitive load and gait features. We show that it is feasible to automatically detect episodes of interest, e.g. straight path, during walking periods of a subject only using IMU data. Our approach detects the steps autonomously and calculates gait features without supervision. The results demonstrate that cognitive load induces a significant increase (p = 0.007) in step-duration variability from 16ms (baseline) to 21ms (load). Our findings demonstrate that IMUs are a proved alternative to static setups that usually require a non-trivial infrastructure, e.g. optical movement tracking.

Lernen und Gedächtnis im Alter

Lernen und Gedachtnis sind zentrale Voraussetzungen fur menschliches Erleben, Verhalten, Identitat und Personlichkeit. Wir sind somit das Produkt aus unseren Lernerfahrungen und unseren Erinnerungen. Aus diesem Grund ist fur viele Menschen der Erhalt der Lernfahigkeit und des Gedachtnisses bis ins hohe Alter von groser Relevanz. Um Lernen und Gedachtnis im Alter besser verstehen zu konnen, ist es wichtig zu wissen, wie sie sich uber die Lebensspanne verandern und wie stark sie miteinander zusammenhangen. Deshalb werden im Folgenden zuerst diese zwei Konzepte in Bezug zueinander gesetzt und danach unabhangig voneinander genauer erlautert. Abschliesend werden aus den Befunden resultierende Interventionsmoglichkeiten aufgezeigt und die wichtigsten Erkenntnisse kurz zusammengefasst.

Gerontopsychology: Ageing is All in Your Head

Gerontopsychology explores the effects of ageing on the brain and on personality. It explores how cognitive functions change with ageing and how individuals can cope with such change in order to maintain a high quality of life. An important age-related cognitive change is dementia, which is a disease that causes people to lose their memory and their capabilities. This chapter describes how common dementia is across Europe and it discusses what we can do to prevent it.

Psychologie der Hochaltrigkeit:Kognitive Entwicklung im hohen Alter

In der Entwicklungspsychologie der Lebensspanne (Baltes 1990; Martin &; Kliegel 2008) wird die Gleichwertigkeit aller Lebensphasen fur die lebenslange Entwicklung betont. Wahrend es fur die meisten Altersbereiche Erkenntnisse uber Entwicklungs- und Adaptationsprozesse und zur kognitiven Entwicklung gibt, ist die Psychologie des sehr hohen Alters aufgrund der bisher nur selten verfugbaren Langsschnittdaten starker in der Charakterisierung von Eigenschaften von Personen als in der Charakterisierung von Entwicklungsprozessen. Wir gehen daher im vorliegenden Kapitel auf der Basis einer kurzen Geschichte der Psychologie des sehr hohen Alters zunachst der Frage nach, welche Langsschnittdaten international zu Prozessen kognitiver Entwicklung im sehr hohen Alter vorliegen. Anhand von drei beispielhaft ausgewahlten Studien wird die Befundlage beschrieben. Schlieslich gehen wir auf die besonderen methodischen und theoretischen Herausforderungen in der langsschnittlichen Erforschung des sehr hohen Alters ein und skizzieren einen konzeptionellen Rahmen fur die zukunftige Erforschung von Entwicklungsprozessen im sehr hohen Alter.

Hochaltrigkeit: Herausforderungen in Gegenwart und Zukunft biopsychosozialer Arbeit

In der Entwicklungspsychologie der Lebensspanne (Baltes 1990; Martin &Kliegel 2008) wird die Gleichwertigkeit aller Lebensphasen fur die lebenslange Entwicklung betont. Wahrend es fur die meisten Altersbereiche Erkenntnisse uber Entwicklungs- und Adaptationsprozesse und zur kognitiven Entwicklung gibt, ist die Psychologie des sehr hohen Alters aufgrund der bisher nur selten verftigbaren Langsschnittdaten starker in der Charakterisierung von Eigenschaften von Personen als in der Charakterisierung von Entwicklungsprozessen. Wir gehen daher im vorliegenden Kapitel auf der Basis einer kurzen Geschichte der Psychologiedes sehr hohen Alters zunachst der Frage nach, welche Langsschnittdaten international zu Prozessen kognitiver Entwicklung im sehr hohen Alter vorliegen. Anhand von drei beispielhaft ausgewahlten Studien wird die Befundlage beschrieben. Schlieslich gehen wir auf die besonderen methodischen und theoretischen Herausforderungen in der langsschnittlichen Erforschung des sehr hohen Alters ein und skizzieren einen konzeptionellen Rahmen fur die zukunftige Erforschung von Entwicklungsprozessen im sehr hohen Alter.