Quality of self-reported cognition: effects of age and gender on spatial navigation self-reports.

Subjective measures of cognitive abilities are often used in various environments, such as clinical, experimental, and professional settings. Here, we assess the quality of such measures, specifically looking into the impact of age and gender. Spatial navigation ability will be used as an exemplary case, given its large individual variation and relevance to the healthy aging process. With a navigation experiment and a self-report questionnaire, the objective and subjective navigation performance of 7150 participants (age 18-89 years) was measured. Results showed the participants provided informative estimates of their cognitive performance. However, strong systematic biases were present related to age and gender. Overestimation increased with increasing age. Overestimation was also found for males, whereas underestimation was found for females. Consideration of such biases is recommended when implementing self-report measures of cognition and considering the potential impact these biases may have on cognitive functioning itself.

Spatial navigation performance in people with multiple sclerosis-a large-scale online study.

OBJECTIVE: Spatial navigation has a crucial function in daily life activities, and is therefore strongly linked to quality of life, autonomy, and mobility. Navigation has been shown to be frequently impaired after forms of acquired brain injury, but the impact of MS on navigation ability has yet to be studied. A better understanding of potential navigation problems in this population could improve patient care. Therefore the aim of the current study was to measure objective and subjective navigation performance in people with MS. METHODS: Performance of a large sample of people with MS (N = 359) was compared to a group of matched controls. Additionally, the impact of ambulation and self-reported cognitive performance was studied within the MS sample. Participants filled out the Wayfinding Questionnaire, the patient-reported Expanded Disability Status Scale and the Multiple Sclerosis Neuropsychological Screening Questionnaire for self-report measures. Objective navigation performance was measured with an online navigation test using a virtual environment. RESULTS: Results indicate a lower subjective as well as objective performance in people with MS compared to healthy controls, and a substantial contribution of self-reported cognitive performance on navigation ability. CONCLUSIONS: These findings indicate that spatial navigation can be a significant problem in people with MS, especially in people with MS with other cognitive impairments.

Large-scale assessment of human navigation ability across the lifespan.

Navigation ability is particularly sensitive to aging. Evidence of aging patterns is largely restricted to comparing young adults and elderly and limited in the variety of navigation tasks used. Therefore, we designed a novel task battery to assess navigation ability in a very large, representative sample (N = 11,887, 8-100 years). The main aim was to measure navigation ability across the lifespan in a brief, yet comprehensive manner. Tasks included landmark knowledge, egocentric and allocentric location knowledge, and path knowledge for a route and survey perspective. Additionally, factors that potentially contribute to navigation ability were considered; gender, spatial experience and spatial anxiety. Increase in performance with age in children was found for allocentric location knowledge and for route-based path knowledge. Age related decline was found for all five tasks, each with clearly discernible aging patterns, substantiated the claim that each task distinctively contributes to the assessment of navigation ability. This study provides an in depth examination of navigation ability across dissociable functional domains and describes cognitive changes across the lifespan. The outcome supports the use of this task battery for brief assessment of navigation for experimental and clinical purposes.

Cognitive processing of spatial relations in Euclidean diagrams.

The cognitive processing of spatial relations in Euclidean diagrams is central to the diagram-based geometric practice of Euclid's Elements. In this study, we investigate this processing through two dichotomies among spatial relations-metric vs topological and exact vs co-exact-introduced by Manders in his seminal epistemological analysis of Euclid's geometric practice. To this end, we carried out a two-part experiment where participants were asked to judge spatial relations in Euclidean diagrams in a visual half field task design. In the first part, we tested whether the processing of metric vs topological relations yielded the same hemispheric specialization as the processing of coordinate vs categorical relations. In the second part, we investigated the specific performance patterns for the processing of five pairs of exact/co-exact relations, where stimuli for the co-exact relations were divided into three categories depending on their distance from the exact case. Regarding the processing of metric vs topological relations, hemispheric differences were found for only a few of the stimuli used, which may indicate that other processing mechanisms might be at play. Regarding the processing of exact vs co-exact relations, results show that the level of agreement among participants in judging co-exact relations decreases with the distance from the exact case, and this for the five pairs of exact/co-exact relations tested. The philosophical implications of these empirical findings for the epistemological analysis of Euclid's diagram-based geometric practice are spelled out and discussed.

The Effectiveness of Home-Based Training Software Designed to Influence Strategic Navigation Preferences in Healthy Subjects.

One approach to the rehabilitation of navigation impairments is to train the use of compensatory egocentric or allocentric navigation strategies. Yet, it is unknown whether and to what degree training programs can influence strategic navigation preferences. In validating this approach, the key assumption that strategic preference can be changed by using a navigation training was assessed in a group of healthy participants (n = 82). The training program consisted of a psychoeducation session and a software package that included either allocentric or egocentric navigation exercises in virtual environments. Strategic navigation preference, objective and self-reported spatial abilities were assessed in pre- and post-training sessions. Based on their pre-training strategic preference, participants received either the egocentric training (n = 19) or the allocentric training (n = 21) version of the training. These participants engaged in four training sessions over a period of 2-3 weeks. The second group of participants did not use the training software (n = 43) and served as a control group. The results show that 50% of participants that received the egocentric training shifted from an allocentric to and an egocentric strategic preference. The proportion of participants that switched their strategic preference as a result of the allocentric training was identical to this proportion in the control group (19%). The training did not affect objective and self-reported navigation abilities as measured in the pre- and post-training sessions. We conclude that strategic navigation preferences can be influenced by using home-based training in healthy participants. However, using the current approach, only a preference shift from an allocentric to an egocentric navigation strategy could be achieved. The effectiveness of this navigation strategy training should next be assessed in relevant patient populations.

Healthcare Professionals' Acceptance of Digital Cognitive Rehabilitation.

With technological possibilities in healthcare steadily increasing, more tools for digital cognitive rehabilitation become available. Acceptance of such technological advances is crucial for successful implementation. Therefore, we examined technology acceptance specifically for this form of rehabilitation in a sample of healthcare providers involved in cognitive rehabilitation. An adjusted version of the Technology Acceptance Model (TAM) questionnaire was used, including the subscales for perceived usefulness, perceived ease of use, subjective norm (toward use), and intention to use, which all contribute to actual use of a specific technology. Results indicate a generally favorable attitude toward the use of digital cognitive rehabilitation and positive responses toward the TAM constructs. Only for subjective norm, a neutral mean response was found, indicating that this could pose a potential obstacle toward implementation. Potential differences between subgroups of different age, gender, and professional background were assessed. Age and gender did not affect the attitude toward digital cognitive rehabilitation. Occupational therapists showed lower scores than healthcare psychologists and physiatrists with regard to perceived usefulness, possibly linked to a difference in operational and managerial tasks. The findings of his study stimulate further implementation of digital cognitive rehabilitation, where the role of subjective norms should be specifically considered.

Memory-related perceptual illusions directly affect physical activity in humans.

Perceptual illusions help us understand deficits in human perception, but they also have the potential to serve as treatment methods; e.g., to alleviate phantom limb pain. Treatment effects are usually the direct result of a mismatch between false visual feedback and somatosensory/proprioceptive feedback. We aimed to influence physical activity (walking distance) using a memory-related perceptual illusion that relies on a mismatch between a spatially manipulated virtual reality environment and a weakness of memory for a similar, previously experienced environment. Participants' main task was to reproduce a baseline distance three times, by walking on a treadmill while moving through a virtual reality environment. Depending on condition, the environment was either stretched or compressed relative to the previous session, but participants were not informed about these manipulations. Because false, suggestive information can lead to alterations in memory, especially when conveyed through 'rich' forms of media such as virtual reality, we expected each manipulation to alter memory for the previous environment(s) and we hypothesized that this would influence walking distance. The results for the first time showed that memory-related perceptual illusions can directly affect physical activity in humans. The effects we found are substantial; stretching previously experienced virtual environments led participants to almost double their initial walking distance, whereas compressing the environments resulted in about half of the initial distance. Possible clinical applications arising from these findings are discussed.

A Usability Study of a Serious Game in Cognitive Rehabilitation: A Compensatory Navigation Training in Acquired Brain Injury Patients.

Acquired brain injury patients often report navigation impairments. A cognitive rehabilitation therapy has been designed in the form of a serious game. The aim of the serious game is to aid patients in the development of compensatory navigation strategies by providing exercises in 3D virtual environments on their home computers. The objective of this study was to assess the usability of three critical gaming attributes: movement control in 3D virtual environments, instruction modality and feedback timing. Thirty acquired brain injury patients performed three tasks in which objective measures of usability were obtained. Mouse controlled movement was compared to keyboard controlled movement in a navigation task. Text-based instructions were compared to video-based instructions in a knowledge acquisition task. The effect of feedback timing on performance and motivation was examined in a navigation training game. Subjective usability ratings of all design options were assessed using questionnaires. Results showed that mouse controlled interaction in 3D environments is more effective than keyboard controlled interaction. Patients clearly preferred video-based instructions over text-based instructions, even though video-based instructions were not more effective in context of knowledge acquisition and comprehension. No effect of feedback timing was found on performance and motivation in games designed to train navigation abilities. Overall appreciation of the serious game was positive. The results provide valuable insights in the design choices that facilitate the transfer of skills from serious games to real-life situations.

Distance comparisons in virtual reality: effects of path, context, and age.

In this large scale, individual differences study (N = 521), the effects of cardinal axes of an environment and the path taken between locations on distance comparisons were assessed. The main goal was to identify if and to what extent previous findings in simple 2D tasks can be generalized to a more dynamic, three-dimensional virtual reality environment. Moreover, effects of age and gender were assessed. After memorizing the locations of six objects in a circular environment, participants were asked to judge the distance between objects they encountered. Results indicate that categorization (based on the cardinal axes) was present, as distances within one quadrant were judged as being closer together, even when no visual indication of the cardinal axes was given. Moreover, strong effects of the path taken between object locations were found; objects that were near on the path taken were perceived as being closer together than objects that were further apart on this path, regardless of the metric distance between the objects. Males outperformed females in distance comparison, but did not differ in the extent of the categorization and path effects. Age also affected performance; the categorization and path effects were highly similar across the age range tested, but the general ability to estimate distances does show a clear pattern increase during development and decrease with aging.