A drift diffusion model analysis of age-related impact on multisensory decision-making processes.

Older adults (OAs) are typically slower and/or less accurate in forming perceptual choices relative to younger adults. Despite perceptual deficits, OAs gain from integrating information across senses, yielding multisensory benefits. However, the cognitive processes underlying these seemingly discrepant ageing effects remain unclear. To address this knowledge gap, 212 participants (18-90 years old) performed an online object categorisation paradigm, whereby age-related differences in Reaction Times (RTs) and choice accuracy between audiovisual (AV), visual (V), and auditory (A) conditions could be assessed. Whereas OAs were slower and less accurate across sensory conditions, they exhibited greater RT decreases between AV and V conditions, showing a larger multisensory benefit towards decisional speed. Hierarchical Drift Diffusion Modelling (HDDM) was fitted to participants' behaviour to probe age-related impacts on the latent multisensory decision formation processes. For OAs, HDDM demonstrated slower evidence accumulation rates across sensory conditions coupled with increased response caution for AV trials of higher difficulty. Notably, for trials of lower difficulty we found multisensory benefits in evidence accumulation that increased with age, but not for trials of higher difficulty, in which increased response caution was instead evident. Together, our findings reconcile age-related impacts on multisensory decision-making, indicating greater multisensory evidence accumulation benefits with age underlying enhanced decisional speed.

A tensor decomposition reveals ageing-induced differences in muscle and grip-load force couplings during object lifting.

Do motor patterns of object lifting movements change as a result of ageing? Here we propose a methodology for the characterization of these motor patterns across individuals of different age groups. Specifically, we employ a bimanual grasp-lift-replace protocol with younger and older adults and combine measurements of muscle activity with grip and load forces to provide a window into the motor strategies supporting effective object lifts. We introduce a tensor decomposition to identify patterns of muscle activity and grip-load force ratios while also characterizing their temporal profiles and relative activation across object weights and participants of different age groups. We then probe age-induced changes in these components. A classification analysis reveals three motor components that are differentially recruited between the two age groups. Linear regression analyses further show that advanced age and poorer manual dexterity can be predicted by the coupled activation of forearm and hand muscles which is associated with high levels of grip force. Our findings suggest that ageing may induce stronger muscle couplings in distal aspects of the upper limbs, and a less economic grasping strategy to overcome age-related decline in manual dexterity.

A novel tool for characterising upper limb function in progressive multiple sclerosis through kinematic assessment.

INTRODUCTION: Current upper limb assessment methods in MS rely on measuring duration in tasks like the nine-hole peg test (9HPT). Kinematic techniques may provide a more useful measure of functional change in clinical and research practice. The aim of this study was to assess upper limb function prospectively in people with progressive MS using a kinematic 3D motion capture system and compare with current measures. METHODS: 42 people with progressive MS (PwPMS) and 15 healthy controls reached-and-grasped different objects whilst recorded by a kinematic assessment system. 9HPT, Expanded Disability Status Scale (EDSS), and patient reported outcome measures (PROs) were collected. All measures were taken at baseline for PwPMS and controls, and again at six months for PwPMS. RESULTS: Relative to controls, PwPMS had significantly longer reaction (0.11 s, p < 0.05) and reach (0.25 s, p < 0.05) times. PwPMS took longer to pick-up (0.34 s, p < 0.05), move (0.14 s, p < 0.05), and place (0.18 s, p < 0.05) objects. PwPMS had lower peak velocities when reaching (7.4 cm/s, p < 0.05) and moving (7.3 cm/s, p < 0.05) objects. Kinematic assessment demonstrated consistent differences between PwPMS with mild and severe upper limb dysfunction as defined by PROs, which were not captured by 9HPT or EDSS in this group. PwPMS demonstrated altered grip apertures profiles, as measured by their ability to complete individual parts of the reach and grasp task, between the baseline and follow-up timepoints. CONCLUSIONS: We have created and tested a novel upper limb function assessment tool which has detected changes and characteristics in hand function, not currently captured by the EDSS and 9HPT.

What Does It Mean to "Age Well" Among British and Javanese Older Adults? A Cross-Cultural Qualitative Study.

OBJECTIVES: This study aimed to investigate perceptions of what it means to "age well" and to explore similarities and differences between a Western and non-Western culture (Britain and Java). METHODS: Qualitative interviews explored how Javanese and British older adults defined aging well, establishing the similarities and differences between cultures. Javanese (n = 14) and British (n = 15) adults aged 61-80 (mean age = 68) participated. The data were analyzed using reflexive thematic analysis and organized with NVivo. RESULTS: Four themes were identified that captured what it means to age well across cultures: (a) good health is a springboard for aging well; (b) holding a positive outlook is a decisive factor in aging well; (c) "having enough" and "feeling safe" provide peace of mind; and (d) spirituality and religiosity provide tranquility. Although both cultures mentioned similar factors, there were variations in the interpretations and emphasis within themes. For example, Javanese participants emphasized the importance of the social environment whereas British participants highlighted the physical environment. DISCUSSION: Differences between cultures are important for understanding how best to support people as they age. For example, in Java, aging well may be best supported by providing a vibrant social environment. For people in Britain, having a safe and secure physical environment may be more important.

A Systematic Review of the Effects of Second-Eye Cataract Surgery on Motor Function.

Cataract removal surgery is one of the most commonly performed surgical procedure in developed countries. The financial and staff resource cost that first-eye cataract surgery incurs, leads to restricted access to second-eye cataract surgery (SES) in some areas, including the United Kingdom. These restrictions have been imposed despite a lack of knowledge about the impact of not performing SES on visuo-motor function. To this end, a systematic literature review was carried out, with the aim of synthesising our present understanding of the effects of SES on motor function. Key terms were searched across four databases, PsycINFO, Medline, Web of Science, and CINAHL. Of the screened studies (K = 499) 13 met the eligibility criteria. The homogeneity between participants, study-design and outcome measures across these studies was not sufficient for meta-analyses and a narrative synthesis was carried out. The evidence from objective sources indicates a positive effect of SES on both mobility and fall rates, however, when considering self-report measures, the reduction in falls associated with SES becomes negligible. The evidence for any positive effect of SES on driving is also mixed, whereby SES was associated with improvements in simulated driving performance but was not associated with changes in driving behaviours measured through in vehicle monitoring. Self-report measures of driving performance also returned inconsistent results. Whilst SES appears to be associated with a general trend towards improved motor function, more evidence is needed to reach any firm conclusions and to best advise policy regarding access to SES in an ageing population. Systematic Review Registration: https://osf.io/7hne6/, identifier INPLASY2020100042.

Attitudes Towards Assisted Dying in Dementia: A Focus Group Study with Younger and Older Adults.

Objectives: To explore attitudes towards assisted dying in dementia (ADID) and the rationales underlying these attitudes, among younger and older adults.Method: We conducted separate focus groups with younger (n = 11) and older adults (n = 14) in the United Kingdom with personal or professional experience of dementia. Discussions were prompted by two vignettes depicting scenarios of ADID. The data were transcribed and analysed using thematic analysis.Results: Though sometimes stronger in the older adults, many of the attitudes and underlying rationales were common across the age groups. Analysis generated four themes: 'Perceptions of the disease', 'A case for empowerment', 'The morality of killing' and 'Logistical complexities'.Conclusions: For some, ADID was a hopeful alternative to the challenges they had witnessed in dementia. For others, the logistical problems surrounding ADID were insurmountable. Discussions were informed and insightful, highlighting the importance of including the general public in this ongoing debate.

Exploring the effects of degraded vision on sensorimotor performance.

PURPOSE: Many people experience unilateral degraded vision, usually owing to a developmental or age-related disorder. There are unresolved questions regarding the extent to which such unilateral visual deficits impact on sensorimotor performance; an important issue as sensorimotor limitations can constrain quality of life by restricting 'activities of daily living'. Examination of the relationship between visual deficit and sensorimotor performance is essential for determining the functional implications of ophthalmic conditions. This study attempts to explore the effect of unilaterally degraded vision on sensorimotor performance. METHODS: In Experiment 1 we simulated visual deficits in 30 participants using unilateral and bilateral Bangerter filters to explore whether motor performance was affected in water pouring, peg placing, and aiming tasks. Experiment 2 (n = 74) tested the hypothesis that kinematic measures are associated with visuomotor deficits by measuring the impact of small visual sensitivity decrements created by monocular viewing on sensorimotor interactions with targets presented on a planar surface in aiming, tracking and steering tasks. RESULTS: In Experiment 1, the filters caused decreased task performance-confirming that unilateral (and bilateral) visual loss has functional implications. In Experiment 2, kinematic measures were affected by monocular viewing in two of three tasks requiring rapid online visual feedback (aiming and steering). CONCLUSIONS: Unilateral visual loss has a measurable impact on sensorimotor performance. The benefits of binocular vision may be particularly important for some groups (e.g. older adults) where an inability to complete sensorimotor tasks may necessitate assisted living. There is an urgent need to develop rigorous kinematic approaches to the quantification of the functional impact of unilaterally degraded vision and of the benefits associated with treatments for unilateral ophthalmic conditions to enable informed decisions around treatment.

Following Instructions in Working Memory: Do Older Adults Show the Enactment Advantage?

OBJECTIVES: In young adults, the ability to verbally recall instructions in working memory is enhanced if the sequences are physically enacted by the participant (self-enactment) or the experimenter (demonstration) during encoding. Here we examine the effects of self-enactment and demonstration at encoding on working memory performance in older and younger adults. METHOD: Fifty young (18-23 years) and 40 older (60-89 years) adults listened to sequences of novel action-object pairs before verbally recalling them in the correct order. There were three different encoding conditions: spoken only, spoken + demonstration, and spoken + self-enactment. We included two different levels of difficulty to investigate whether task complexity moderated the effect of encoding condition and whether this differed between age groups. RESULTS: Relative to the spoken only condition, demonstration significantly improved young and older adults' serial recall performance, but self-enactment only enhanced performance in the young adults, and this boost was smaller than the one gained through demonstration. DISCUSSION: Our findings suggest that additional spatial-motoric information is beneficial for older adults when the actions are demonstrated to them, but not when the individual must enact the instructions themselves.

Cognitive and sensorimotor function in participants being treated for trigeminal neuralgia pain.

BACKGROUND: Trigeminal neuralgia (TN) is an orofacial condition defined by reoccurring, spontaneous, short-lived but excruciating stabbing pain. Pharmacological interventions constitute the first-line treatment for TN, with antiepileptic drugs commonly prescribed. People treated for TN pain with antiepileptic drugs describe cognitive and motor difficulties affecting activities of daily living, and report poorer quality of life. We undertook the first comprehensive objective evaluation of sensorimotor and cognitive performance in participants being treated for TN pain with antiepileptic drugs relative to age-matched controls. METHODS: Participants (43 TN, 41 control) completed a battery of sensorimotor (steering, aiming and tracking) and cognitive (working memory, processing speed, inhibition) tasks. RESULTS: The TN group performed significantly worse than controls on the sensorimotor tracking and aiming tasks and across all cognitive measures. CONCLUSIONS: The data explain why patients treated with antiepileptic drugs report impairment when conducting activities of daily living (given the need for cognitive and motor capability within most of these). The study is an important first step in: (i) ensuring there is adequate information on the impact of pharmacological treatment; (ii) identifying measures to determine optimal medication dosage and track change over time; (iii) creating an evidence base that could allow scientific justification of alternative pain treatment options for TN (e.g. the costs/benefits of surgery).

Predicting the duration of reach-to-grasp movements to objects with asymmetric contact surfaces.

The duration of reach-to-grasp movements is influenced by the size of the contact surfaces, such that grasping objects with smaller contact surface areas takes longer. But what is the influence of asymmetric contact surfaces? In Experiment 1a, participants reached-to-lift wooden blocks off a table top, with the contact locations for the thumb and index finger varying in surface size. The time taken to lift the block was driven primarily by the thumb contact surface, which showed a larger effect size for the dependent variable of movement duration than the index finger's contact surface. In Experiment 1b participants reached-to-grasp (but not lift) the blocks. The same effect was found with duration being largely driven by contact surface size for the thumb. Experiment 2 tested whether this finding generalised to movements towards conical frusta grasped in a different plane mounted off the table top. Experiment 2 showed that movement duration again was dictated primarily by the size of the thumb's contact surface. The thumb contact surface was the visible surface in experiments 1 and 2 so Experiment 3 explored grasping when the index finger's contact surface was visible (participants grasped the frusta with the index finger at the top). An interaction between thumb and finger surface size was now found to determine movement duration. These findings provide the first empirical report of the impact of asymmetric contact surfaces on prehension, and may have implications for scientists who wish to model reach-to-grasp behaviours.

Moving to Capture Children's Attention: Developing a Methodology for Measuring Visuomotor Attention.

Attention underpins many activities integral to a child's development. However, methodological limitations currently make large-scale assessment of children's attentional skill impractical, costly and lacking in ecological validity. Consequently we developed a measure of 'Visual Motor Attention' (VMA)-a construct defined as the ability to sustain and adapt visuomotor behaviour in response to task-relevant visual information. In a series of experiments, we evaluated the capability of our method to measure attentional processes and their contributions in guiding visuomotor behaviour. Experiment 1 established the method's core features (ability to track stimuli moving on a tablet-computer screen with a hand-held stylus) and demonstrated its sensitivity to principled manipulations in adults' attentional load. Experiment 2 standardised a format suitable for use with children and showed construct validity by capturing developmental changes in executive attention processes. Experiment 3 tested the hypothesis that children with and without coordination difficulties would show qualitatively different response patterns, finding an interaction between the cognitive and motor factors underpinning responses. Experiment 4 identified associations between VMA performance and existing standardised attention assessments and thereby confirmed convergent validity. These results establish a novel approach to measuring childhood attention that can produce meaningful functional assessments that capture how attention operates in an ecologically valid context (i.e. attention's specific contribution to visuomanual action).

Eye and hand movement strategies in older adults during a complex reaching task.

The kinematics of upper limb movements and the coordination of eye and hand movements are affected by ageing. These age differences are exacerbated when task difficulty is increased, but the exact nature of these differences remains to be established. We examined the performance of 12 older adults (mean age = 74) and 11 younger adults (mean age = 20) on a multi-phase prehension task. Participants had to reach for a target ball with their preferred hand, pick it up and place it in a tray, then reach for a second target ball and place that in the same tray. On half the trials (stabilising condition), participants were required to hold the tray just above the surface of the table with their non-preferred hand and keep it as still as possible. Hand and eye movements were recorded. Older adults took longer to complete their movements and reached lower peak velocities than the younger adults. Group differences were most apparent in the stabilising condition, suggesting that the added complexity had a greater effect on the performance of the older adults than the young. During pickup, older adults preferred to make an eye movement to the next target as soon as possible, but spent longer fixating the current target during placement, when accuracy requirements were higher. These latter observations suggest that older adults employed a task-dependent eye movement strategy, looking quickly to the next target to allow more time for planning and execution when possible, but fixating on their hand and successful placement of the ball when necessary.

A Systematic Research Review Assessing the Effectiveness of Pursuit Interventions in Spatial Neglect Following Stroke.

Rehabilitation after stroke is imperative for patients with spatial neglect as it can help improve behavioural, social and cognitive outcomes in these patients, and therefore reduce the financial burden on public health services. The main aim of this review is to investigate the effectiveness of active pursuit eye movements for rehabilitation interventions in patients with spatial neglect following stroke. Potential papers for inclusion were gathered by searching key terms in four main databases (AMED, Global Health, PubMed/Medline and PsychInfo) in addition to screening relevant reference lists. Two reviewers independently selected papers for inclusion based on agreed inclusion criteria (n = 9 with 147 participants). Risk of bias was assessed using the QUADAS-2 tool. All papers reported a statistically significant result in patients who received an intervention which used pursuit eye movements, and this was reported both as a short-term (immediate) effect and as a sustained effect up to 8 weeks after treatment. These effects were also reported in comparison with interventions using saccadic eye movements. One study also reported increased neural activity in a number of brain regions following pursuit-based intervention. Overall, there is good evidence in support of pursuit intervention used in the rehabilitation of stroke and spatial neglect over and above traditional interventions based on saccadic eye movements. Future research should aim to increase sample sizes, provide information on statistical power, record accurate eye movement responses and use randomised designs to reduce selection bias.

A geometric and dynamic affordance model of reaches-to-grasp: Men take greater risks than women.

Mon-Williams and Bingham (2011) developed an affordance model of the spatial structure of reaches-to-grasp. With a single free parameter (P), the model predicted the safety margins (SMs) exhibited in maximum grasp apertures (MGAs), during the approach of a hand to a target object, as a function of an affordance measure of object size and a functional measure of hand size. An affordance analysis revealed that object size is determined by a diagonal through the object, called the maximum object extent. Mon-Williams and Bingham provided no theoretical account for the empirically determined values of P. We now address this question. Snapp-Childs and Bingham (2009) augmented Warren's (1984) geometric affordance scaling model with a dynamical component determined by the stability of the motor performance. Because P was found to vary with the speeds of reaches, we incorporated a measure of the variability of performance into the model to yield predictions of P. We also found that P varied with gender. In respect to the size of safety margins, women were more conservative in taking risks then men. Finally, following Warren (1984), the classic paradigm for testing affordance models is to test the scaling relations with both small and large participants. We tested small- and large-handed men and small- and large-handed women and found that the new parameter free model successfully accounted for the spatial structure of reaches-to-grasp.

The 50s cliff: perceptuo-motor learning rates across the lifespan.

We recently found that older adults show reduced learning rates when learning a new pattern of coordinated rhythmic movement. The purpose of this study was to extend that finding by examining the performance of all ages across the lifespan from the 20 s through to the 80 s to determine how learning rates change with age. We tested whether adults could learn to produce a novel coordinated rhythmic movement (90° relative phase) in a visually guided unimanual task. We determined learning rates to quantify changes in learning with age and to determine at what ages the changes occur. We found, as before, that learning rates of participants in their 70 s and 80 s were half those of participants in their 20 s. We also found a gradual slow decline in learning rate with age until approximately age 50, when there was a sudden drop to a reduced learning rate for the 60 though 80 year olds. We discuss possible causes for the "50 s cliff" in perceptuo-motor learning rates and suggest that age related deficits in perception of complex motions may be the key to understanding this result.

Perturbation of perceptual units reveals dominance hierarchy in cross calibration.

Bingham and Pagano (1998) argued that calibration is an intrinsic component of perception-action that yields accurate targeted actions. They described calibration as of a mapping from embodied units of perception to embodied units of action. This mapping theory yields a number of predictions. The authors tested 2 of them. The 1st prediction is that change in the size of perceptual units should yield a corresponding change in the slope of the relation between response distances and actual target distances. In Experiment 1, the authors tested this prediction by manipulating interpupillary distance (IPD) as the unit for binocular perception of distance using vergence angles. In Experiment 2, they manipulated eye height (EH) as the unit for monocular perception of distance using elevation angles. In both cases, the results confirmed the predictions. The 2nd prediction was that perceptual units should interact to cross calibrate one another according to a dominance hierarchy among the units. The theory predicts a more temporally stable unit is used to calibrate a less stable unit but not the reverse. EH units change frequently, but IPD units do not, so IPD should be dominant. Simultaneously available IPD and EH units were perturbed successively (without feedback). As predicted, EH was recalibrated by IPD, but IPD was not recalibrated by EH. The mapping among units theory of calibration was thus supported.

Calibration is action specific but perturbation of perceptual units is not.

G. P. Bingham and C. C. Pagano (1998, The necessity of a perception/action approach to definite distance perception: Monocular distance perception to guide reaching. Journal of Experimental Psychology: Human Perception and Performance, 24, 145-168) argued that metric space perception should be investigated using relevant action measures because calibration is an intrinsic component of perception/action that yields accurate targeted actions. They described calibration as a mapping from embodied units of perception to embodied units of action. This mapping theory yields a number of predictions. We tested two of them. The first prediction is that calibration should be action specific because what is calibrated is a mapping from perceptual units to a unit of action. Thus, calibration does not generalize to other actions. This prediction is consistent with the "action-specific approach" to calibration (D. R. Proffitt, 2008, An action specific approach to spatial perception. In R. L. Klatzky, B. MacWhinney, & M. Behrmann (Eds.), Embodiment, ego-space and action (pp. 179-202). New York, NY: Psychology Press.). The second prediction is that a change in perceptual units should generalize to all relevant actions that are guided using that perceptual information. The same perceptual units can be mapped to different actions. Change in the unit affects all relevant actions. This prediction is consistent with the "general purpose perception approach" (J. M. Loomis & J. W. Philbeck, 2008, Measuring spatial perception with spatial updating and action. In R. L. Klatzky, B. MacWhinney, & M. Behrmann (Eds.), Embodiment, ego-space and action (pp. 1-43). New York, NY: Psychology Press). In Experiment 1, two targeted actions, throwing and extended reaching were tested to determine if they were comparable in precision and in response to distorted calibration. They were. Comparing these actions, the first prediction was tested in Experiment 2 and confirmed. The second prediction was tested in Experiment 3 and confirmed. The action-specific and general purpose perception approaches each fail to predict the alternative results predicted by the other. Both sets of results were predicted by the mapping among embodied units theory of calibration.

Perceptuo-motor learning rate declines by half from 20s to 70/80s.

This study examined perception-action learning in younger adults in their 20s compared to older adults in their 70s and 80s. The goal was to provide, for the first time, quantitative estimates of perceptuo-motor learning rates for each age group and to reveal how these learning rates change between these age groups. We used a visual coordination task in which participants are asked to learn to produce a novel-coordinated rhythmic movement. The task has been studied extensively in young adults, and the characteristics of the task are well understood. All groups showed improvement, although learning rates for those in their 70s and 80s were half the rate for those in their 20s. We consider the potential causes of these differences in learning rates by examining performance across the different coordination patterns examined as well as recent results that reveal age-related deficits in motion perception.

Reaching a better understanding of the control of bimanual movements in older adults.

The ability to interact skilfully with the environment is essential for independent living and therefore a critical factor for the aging population. Here we investigate the differences between young and older adults in a bimanual reaching task where the goal is to bring two objects together to the same location with a synchronous placement. Older (mean age 74) and young (mean age 20) adults were asked to pick up two spatially disparate objects, one in each hand, and bring them together to place them in one of three trays laid out in front of them from left to right. The results showed that the older adults were no more detrimentally affected than the young by asymmetric bimanual movements compared to symmetric ones, and both groups completed their movements in the same time. Nevertheless, compared to the young, the older adult group produced reaches characterised by higher peak velocities (although this effect was marginal), shorter hover times, and where the movement distance varied for each hand the scaling of the kinematic profile across the two limbs diverged from that found with younger participants. They then spent longer than the young in the final adjustment phase and during this phase they made more adjustments than the young, and as a result were more synchronous in terms of the final placement of the objects. It seems that the older adults produced reach movements that were designed to reach the vicinity of the tray quite rapidly, after which time they made discreet adjustments to their initial trajectories in order to exercise the precision necessary to place the objects in the tray. These findings are consistent with the idea that older adults have problems using online control (as they wait until they can fixate both objects before making adjustments).

The reliance on visual feedback control by older adults is highlighted in tasks requiring precise endpoint placement and precision grip.

There is an ongoing debate as to whether a greater degree of sensory-motor control is required to maintain skills as humans progress to be septuagenarians. Here, we investigate the dependence of older participants upon vision to execute skilled prehension movements. In a first experiment, participants were required to place a small, round peg in one of three randomly cued holes. A mirror apparatus was used to create conditions where they could always see the target locations, but vision of their hand approaching the target could be removed, and we explored end position accuracy. In a second experiment, we examined the ability of participants to precisely control their grasp action under conditions where they could see the objects but not their hands completing the action. The results showed that in Experiment 1, the older adults undershot the target in their primary submovement and hence had to move further in their secondary movement to achieve their goal. In Experiment 2, the older adults spent longer in the final adjustment phase (a near zero velocity phase at the end of the reach) when vision of the hand was unavailable. These findings suggest that older adults are indeed more reliant on visual feedback than the young in tasks that require precise manual control, and this clarifies conflicting accounts in the prior literature.