A Comparison of the Effect of Physical Activity and Cognitive Training on Dual-Task Performance in Older Adults.

OBJECTIVES: Studies suggest that cognitive training and physical activity can improve age-related deficits in dual-task performances. However, both of these interventions have never been compared in the same study. This article investigates the improvement in dual-task performance in 2 types of exercise training groups and a cognitive training group and explores if there are specific dual-task components that are more sensitive or more likely to improve following each type of training. METHODS: Seventy-eight healthy inactive participants older than the age of 60 (M = 69.98, SD = 5.56) were randomized to one of three 12-week training programs: aerobic training (AET) = 26, gross motor abilities (GMA) = 27, and cognition (COG) = 25. Before and after the training program, the participants underwent physical fitness tests, and cognitive evaluations involving a computerized cognitive dual task. The AET consisted of high- and low-intensity aerobic training, the GMA of full-body exercises focusing on agility, balance, coordination, and stretching, and the COG of tablet-based exercises focusing on executive functions. RESULTS: Repeated-measures analysis of variance on reaction time data revealed a group × time interaction (F(2,75) = 11.91, p < .01) with COG having the greatest improvement, followed by a significant improvement in the GMA group. Secondary analysis revealed the COG to also improve the intraindividual variability in reaction time (F(1,24) = 8.62, p < .01), while the GMA improved the dual-task cost (F(1,26) = 12.74, p < .01). DISCUSSION: The results show that physical and cognitive training can help enhance dual-task performance by improving different aspects of the task, suggesting that different mechanisms are in play.

Investigation of the Effects of Home-Based Exercise and Cognitive Training on Cognitive and Physical Functions in Cardiac Patients: The COVEPICARDIO Study Protocol of a Randomized Clinical Trial.

Introduction: During the COVID-19 pandemic, confinement measures are likely to produce collateral damage to health (stress, confusion, anxiety), especially in frail individuals and those living with cardiovascular disease (CVD). In cardiac patients in particular, these measures dramatically increase the level of physical inactivity and sedentary lifestyle, which can decrease cardiorespiratory capacity and increase the risk of acute events, rehospitalization, and depressive syndromes. Maintaining a minimum level of physical activity and cognitive stimulation during the COVID-19 crisis is essential for cardiac patients. This study is designed to document the effects of 6 months of home-based physical exercise alone or combined with cognitive training on cognitive and physical functions in patients with CVD over 50 years old. Methods and Analysis: 122 patients (>50 years old) with stable CVD and no contraindication to perform physical exercise training will be recruited and randomly assigned to one of the 2 following arms: (1) Home-based physical exercise alone, (2) Home-based physical exercise combined with cognitive training. The intervention lasts 6 months, with remote assessments performed prior to, mid and post-training. A follow-up 6 months after the end of the intervention (12 month) is also proposed. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as performances on measures of executive functions, processing speed, and episodic memory. The secondary outcome is physical performance, including balance, gait and mobility, leg muscle strength and estimated cardiorespiratory fitness. Tertiary outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported online questionnaires. Discussion: With the COVID-19 crisis, there is a critical need for remote exercise and cognitive training, and to further investigate this topic, in particular for cardiac patients. The present context can be viewed as an opportunity to perform a major shift from center-based programs to home-based physical exercise. This is especially important to reach out to older adults living in remote areas, where access to such interventions is limited. ClinicalTrials.gov: [https://clinicaltrials.gov/ct2/show/NCT04661189], NCT04661189.

COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial.

BACKGROUND: In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults' cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older. METHODS: One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews' questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey). DISCUSSION: This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited. TRIAL REGISTRATION: Clinical trial Identifier NCT04635462 . COVEPIC was retrospectively registered on November 19, 2020.

Opposing effects of cortisol on learning and memory in children using spatial versus response-dependent navigation strategies.

Previous studies showed that healthy young adults who spontaneously use caudate nucleus-dependent strategies on a virtual navigation task, have significantly lower basal levels of cortisol compared with adults who use hippocampus-dependent spatial navigation strategies. In the current paper, we assessed the relation between basal cortisol levels and learning using a virtual navigation task in children. We show that basal cortisol level has a differential effect on learning and memory between children using spatial and response navigation strategies. Specifically, cortisol was found to be beneficial for learning performance in children using spatial strategies, such that higher levels of cortisol were associated with more efficient learning in a virtual maze. In contrast, cortisol had a deleterious effect on learning the virtual maze in children using response strategies, such that higher cortisol levels were associated with increased spatial working memory errors. Based on these results, individual differences in navigation strategy could help explain contradictory results in the literature showing that cortisol can have either a positive or negative association with learning and memory performance.

Caudate nucleus-dependent navigation strategies are associated with increased risk-taking and set-shifting behavior.

When people navigate, they use strategies dependent on one of two memory systems. The hippocampus-based spatial strategy consists of using multiple landmarks to create a cognitive map of the environment. In contrast, the caudate nucleus-based response strategy is based on the memorization of a series of turns. Importantly, response learners display more gray matter and functional activity in the caudate nucleus and less gray matter in the hippocampus. In parallel, the caudate nucleus is involved in decision-making by mediating attention toward rewards and in set-shifting by mediating preparatory actions. The present study, therefore, examined the link between navigational strategy use, that are associated with gray matter differences in the caudate nucleus and hippocampus, and decision-making and set-shifting performance. Fifty-three participants completed the 4 on 8 virtual maze, the Iowa Gambling Task (IGT), the Wisconsin Card Sorting Test-64 (WCST-64), and a task-switching test. The results revealed that people who use response strategies displayed increased risk-taking behavior in the IGT compared to the people using hippocampus-dependent spatial strategies. Response strategy was also associated with enhanced set-shifting performance in the WCST-64 and task-switching test. These results confirm that risk-taking and set-shifting behavior, that are differentially impacted by the caudate nucleus and hippocampus memory systems, can be predicted by navigational strategy.

Autistic traits in neurotypical individuals are associated with increased landmark use during navigation.

People adopt two distinct learning strategies during navigation. "Spatial learners" navigate by building a cognitive map using environmental landmarks, and display more grey matter in the hippocampus. Conversely, "response learners" memorize a series of rigid turns to navigate and display more grey matter in the caudate nucleus of the striatum. Evidence has linked these two structures with autism spectrum disorder (ASD) and autistic traits in non-clinical populations. Both people with ASD and neurotypical people with higher levels of autistic traits have been shown to display more grey matter in the hippocampus and less functional activity in the caudate nucleus. We therefore tested 56 healthy participants who completed the Autism Quotient (AQ) Scale and the 4-on-8 Virtual Maze (4/8 VM), which determines the reliance on landmarks during navigation. We found that people who relied on landmarks during navigation also displayed significantly higher scores on the AQ Scale. Because spatial strategies are associated with increased attention to environmental landmark use and are supported by the hippocampus, our results provide a potential behavioral mechanism linking higher autistic traits (e.g., increased attention to detail and increased sensory processes) to increased hippocampal grey matter.

Playing Super Mario increases oculomotor inhibition and frontal eye field grey matter in older adults.

Aging is associated with cognitive decline and decreased capacity to inhibit distracting information. Video game training holds promise to increase inhibitory mechanisms in older adults. In the current study, we tested the impact of 3D-platform video game training on performance in an antisaccade task and on related changes in grey matter within the frontal eye fields (FEFs) of older adults. An experimental group (VID group) engaged in 3D-platform video game training over a period of 6 months, while an active control group was trained on piano lessons (MUS group), and a no-contact control group did not participate in any intervention (CON group). Increased performance in oculomotor inhibition, as measured by the antisaccade task, and increased grey matter in the right FEF was observed uniquely in the VID group. These results demonstrate that 3D-platform video game training can improve inhibitory control known to decline with age.