Concussion can increase the risk of visually induced motion sickness.

Concussion can lead to various symptoms such as balance problems, memory impairments, dizziness, and/or headaches. It has been previously suggested that during self-motion relevant tasks, individuals with concussion may rely heavily on visual information to compensate for potentially less reliable vestibular inputs and/or problems with multisensory integration. As such, concussed individuals may also be more sensitive to other visually-driven sensations such as visually induced motion sickness (VIMS). To investigate whether concussed individuals are at elevated risk of experiencing VIMS, we exposed participants with concussion (n = 16) and healthy controls (n = 15) to a virtual scene depicting visual self-motion down a grocery store aisle at different speeds. Participants with concussion were further separated into symptomatic and asymptomatic groups. VIMS was measured with the SSQ before and after stimulus exposure, and visual dependence, self-reported dizziness, and somatization were recorded at baseline. Results showed that concussed participants who were symptomatic demonstrated significantly higher SSQ scores after stimulus presentation compared to healthy controls and those who were asymptomatic. Visual dependence was positively correlated with the level of VIMS in healthy controls and participants with concussion. Our results suggest that the presence of concussion symptoms at time of testing significantly increased the risk and severity of VIMS. This finding is of relevance with regards to the use of visual display devices such as Virtual Reality applications in the assessment and rehabilitation of individuals with concussion.

Effects of the BalanCI on Working Memory and Balance in Children and Young Adults With Cochleovestibular Dysfunction.

OBJECTIVES: This study aimed to: (1) determine the interaction between cognitive load and balance in children and young adults with bilateral cochleovestibular dysfunction who use bilateral cochlear implants (CIs) and (2) determine the effect of an auditory balance prosthesis (the BalanCI) on this interaction. Many (20 to 70%) children with sensorineural hearing loss experience some degree of vestibular loss, leading to poorer balance. Poor balance could have effects on cognitive resource allocation which might be alleviated by the BalanCI as it translates head-referenced cues into electrical pulses delivered through the CI. It is hypothesized that children and young adults with cochleovestibular dysfunction will demonstrate greater dual-task costs than typically-developing children during dual balance-cognition tasks, and that BalanCI use will improve performance on these tasks. DESIGN: Study participants were 15 typically-developing children (control group: mean age ± SD = 13.6 ± 2.75 years, 6 females) and 10 children and young adults who use bilateral CIs and have vestibular dysfunction (CI-V group: mean age ± SD=20.6 ± 5.36 years, 7 females). Participants completed two working memory tasks (backward auditory verbal digit span task and backward visuospatial dot matrix task) during three balance conditions: seated, standing in tandem stance with the BalanCI off, and standing in tandem stance with the BalanCI on. Working memory performance was quantified as total number of correct trials achieved. Postural stability was quantified as translational and rotational path length of motion capture markers worn on the head, upper body, pelvis, and feet, normalized by trial time. RESULTS: Relative to the control group, children and young adults in the CI-V group exhibited poorer overall working memory across all balance conditions ( p = 0.03), poorer translational postural stability (larger translational path length) during both verbal and visuospatial working memory tasks ( p < 0.001), and poorer rotational stability (larger rotational path length) during the verbal working memory task ( p = 0.026). The CI-V group also exhibited poorer translational ( p = 0.004) and rotational ( p < 0.001) postural stability during the backward verbal digit span task than backward visuospatial dot matrix task; BalanCI use reduced this stability difference between verbal and visuospatial working memory tasks for translational stability overall ( p > 0.9), as well as for rotational stability during the maximum working memory span (highest load) participants achieved in each task ( p = 0.91). CONCLUSIONS: Balance and working memory were impaired in the CI-V group compared with the control group. The BalanCI offered subtle improvements in stability in the CI-V group during a backward verbal working memory task, without producing a negative effect on working memory outcomes. This study supports the feasibility of the BalanCI as a balance prosthesis for individuals with cochleovestibular impairments.

At-home computerized executive-function training to improve cognition and mobility in normal-hearing adults and older hearing aid users: a multi-centre, single-blinded randomized controlled trial.

BACKGROUND: Hearing loss predicts cognitive decline and falls risk. It has been argued that degraded hearing makes listening effortful, causing competition for higher-level cognitive resources needed for secondary cognitive or motor tasks. Therefore, executive function training has the potential to improve cognitive performance, in turn improving mobility, especially when older adults with hearing loss are engaged in effortful listening. Moreover, research using mobile neuroimaging and ecologically valid measures of cognition and mobility in this population is limited. The objective of this research is to examine the effect of at-home cognitive training on dual-task performance using laboratory and simulated real-world conditions in normal-hearing adults and older hearing aid users. We hypothesize that executive function training will lead to greater improvements in cognitive-motor dual-task performance compared to a wait-list control group. We also hypothesize that executive function training will lead to the largest dual-task improvements in older hearing aid users, followed by normal-hearing older adults, and then middle-aged adults. METHODS: A multi-site (Concordia University and KITE-Toronto Rehabilitation Institute, University Health Network) single-blinded randomized controlled trial will be conducted whereby participants are randomized to either 12 weeks of at-home computerized executive function training or a wait-list control. Participants will consist of normal-hearing middle-aged adults (45-60 years old) and older adults (65-80 years old), as well as older hearing aid users (65-80 years old, ≥ 6 months hearing aid experience). Separate samples will undergo the same training protocol and the same pre- and post-evaluations of cognition, hearing, and mobility across sites. The primary dual-task outcome measures will involve either static balance (KITE site) or treadmill walking (Concordia site) with a secondary auditory-cognitive task. Dual-task performance will be assessed in an immersive virtual reality environment in KITE's StreetLab and brain activity will be measured using functional near infrared spectroscopy at Concordia's PERFORM Centre. DISCUSSION: This research will establish the efficacy of an at-home cognitive training program on complex auditory and motor functioning under laboratory and simulated real-world conditions. This will contribute to rehabilitation strategies in order to mitigate or prevent physical and cognitive decline in older adults with hearing loss. TRIAL REGISTRATION: Identifier: NCT05418998. https://clinicaltrials.gov/ct2/show/NCT05418998.

Beyond the Eye: Multisensory Contributions to the Sensation of Illusory Self-Motion (Vection).

Vection is typically defined as the embodied illusion of self-motion in the absence of real physical movement through space. Vection can occur in real-life situations (e.g., 'train illusion') and in virtual environments and simulators. The vast majority of vection research focuses on vection caused by visual stimulation. Even though visually induced vection is arguably the most compelling type of vection, the role of nonvisual sensory inputs, such as auditory, biomechanical, tactile, and vestibular cues, have recently gained more attention. Non-visual cues can play an important role in inducing vection in two ways. First, nonvisual cues can affect the occurrence and strength of vection when added to corresponding visual information. Second, nonvisual cues can also elicit vection in the absence of visual information, for instance when observers are blindfolded or tested in darkness. The present paper provides a narrative review of the literature on multimodal contributions to vection. We will discuss both the theoretical and applied relevance of multisensory processing as related to the experience of vection and provide design considerations on how to enhance vection in various contexts.

Feasibility of a Home-Based Cognitive-Physical Exercise Program in Patients With Chronic Obstructive Pulmonary Disease: Protocol for a Feasibility and Pilot Randomized Controlled Trial.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a progressive condition associated with physical and cognitive impairments contributing to difficulty in performing activities of daily living (ADLs) that require dual tasking (eg, walking and talking). Despite evidence showing that cognitive decline occurs among patients with COPD and may contribute to functional limitations and decreased health-related quality of life (HRQL), pulmonary rehabilitation continues to focus mainly on physical training (ie, aerobic and strength exercises). An integrated cognitive and physical training program compared to physical training alone may be more effective in increasing dual-tasking ability among people living with COPD, leading to greater improvements in performance of ADLs and HRQL. OBJECTIVE: The aims of this study are to evaluate the feasibility of an 8-week randomized controlled trial of home-based, cognitive-physical training versus physical training for patients with moderate to severe COPD and derive preliminary estimates of cognitive-physical training intervention efficacy on measures of physical and cognitive function, dual task performance, ADLs, and HRQL. METHODS: A total of 24 participants with moderate to severe COPD will be recruited and randomized into cognitive-physical training or physical training. All participants will be prescribed an individualized home physical exercise program comprising 5 days of moderate-intensity aerobic exercise (30-50 minutes/session) and 2 days of whole-body strength training per week. The cognitive-physical training group will also perform cognitive training for approximately 60 minutes, 5 days per week via the BrainHQ platform (Posit Science Corporation). Participants will meet once weekly with an exercise professional (via videoconference) who will provide support by reviewing the progression of their training and addressing any queries. Feasibility will be assessed through the recruitment rate, program adherence, satisfaction, attrition, and safety. The intervention efficacy regarding dual task performance, physical function, ADLs, and HRQL will be evaluated at baseline and at 4 and 8 weeks. Descriptive statistics will be used to summarize intervention feasibility. Paired 2-tailed t tests and 2-tailed t tests will be used to compare the changes in the outcome measures over the 8-week study period within and between the 2 randomized groups, respectively. RESULTS: Enrollment started in January 2022. It is estimated that the enrollment period will be 24 months long, with data collection to be completed by December 2023. CONCLUSIONS: A supervised home-based cognitive-physical training program may be an accessible intervention to improve dual-tasking ability in people living with COPD. Evaluating the feasibility and effect estimates is a critical first step to inform future clinical trials evaluating this approach and its effects on physical and cognitive function, ADL performance, and HRQL. TRIAL REGISTRATION: ClinicalTrials.gov NCT05140226; https://clinicaltrials.gov/ct2/show/NCT05140226. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48666.

Evaluating the use of a balance prosthesis during balance perturbations in children and young adults with cochleovestibular dysfunction.

Study objectives were to: (1) quantify stability in children and young adults using cochlear implants with concurrent cochleovestibular dysfunction (CI-V) during balance perturbations and (2) to assess effects of an auditory head-referencing device (BalanCI) on their stability. The BalanCI provides auditory feedback via cochlear implants to cue posture and potentially avoid falling in children with CI-V. It was hypothesized that children and young adults with CI-V respond with larger movements to floor perturbations than typically-developing peers (controls) and that BalanCI use decreases these movements. Motion in response to treadmill perturbations was captured by markers on the head, torso, and feet in eight CI-V and 15 control participants. Stability (area under the curve of motion displacement) and peak displacement latencies were measured. The CI-V group demonstrated less stability and slower responses than the control group during medium and large backwards perturbations (p's < 0.01). In the CI-V group, BalanCI use improved stability during large backwards perturbations (p < 0.001), but worsened stability during large sideways perturbations (p's < 0.001). Children and young adults with CI-V move more to remain upright during perturbations than typically-developing peers. The BalanCI has potential to aid physical/vestibular therapy in children with CIs who have poor balance.

Automated Vehicles for People With Dementia: A "Tremendous Potential" That "Has Ways to go"-Reports of a Qualitative Study.

BACKGROUND AND OBJECTIVES: The prospect of automated vehicles (AVs) has generated excitement among the public and the research community about their potential to sustain the safe driving of people with dementia. However, no study to date has assessed the views of people with dementia on whether AVs may address their driving challenges. RESEARCH DESIGN AND METHODS: This mixed-methods study included two phases, completed by nine people with dementia. Phase I included questionnaires and individual semistructured interviews on attitudes toward using different types of AVs (i.e., partially or fully automated). Interpretative phenomenological analysis was used to assess participants' underlying reasons for and against AV use. The participants' identified reasons against AV use informed the focus group discussions in Phase II, where participants were asked to reflect on potential means of overcoming their hesitancies regarding AV use. RESULTS: The results showed that people with dementia might place higher levels of trust in fully automated compared to partially automated AVs. In addition, while people with dementia expressed multiple incentives to use AVs (e.g., regaining personal freedom), they also had hesitations about AV use. These hesitancies were based on their perceptions about AVs (e.g., cost), their own abilities (i.e., potential challenges operating an AV), and driving conditions (i.e., risk of driving in adverse weather conditions). DISCUSSION AND IMPLICATIONS: The findings of this study can help promote the research community's appreciation and understanding of the significant potential of AVs for people with dementia while elucidating the potential barriers of AV use by people with dementia.

Multisensory visual-vestibular training improves visual heading estimation in younger and older adults.

Self-motion perception (e.g., when walking/driving) relies on the integration of multiple sensory cues including visual, vestibular, and proprioceptive signals. Changes in the efficacy of multisensory integration have been observed in older adults (OA), which can sometimes lead to errors in perceptual judgments and have been associated with functional declines such as increased falls risk. The objectives of this study were to determine whether passive, visual-vestibular self-motion heading perception could be improved by providing feedback during multisensory training, and whether training-related effects might be more apparent in OAs vs. younger adults (YA). We also investigated the extent to which training might transfer to improved standing-balance. OAs and YAs were passively translated and asked to judge their direction of heading relative to straight-ahead (left/right). Each participant completed three conditions: (1) vestibular-only (passive physical motion in the dark), (2) visual-only (cloud-of-dots display), and (3) bimodal (congruent vestibular and visual stimulation). Measures of heading precision and bias were obtained for each condition. Over the course of 3 days, participants were asked to make bimodal heading judgments and were provided with feedback ("correct"/"incorrect") on 900 training trials. Post-training, participants' biases, and precision in all three sensory conditions (vestibular, visual, bimodal), and their standing-balance performance, were assessed. Results demonstrated improved overall precision (i.e., reduced JNDs) in heading perception after training. Pre- vs. post-training difference scores showed that improvements in JNDs were only found in the visual-only condition. Particularly notable is that 27% of OAs initially could not discriminate their heading at all in the visual-only condition pre-training, but subsequently obtained thresholds in the visual-only condition post-training that were similar to those of the other participants. While OAs seemed to show optimal integration pre- and post-training (i.e., did not show significant differences between predicted and observed JNDs), YAs only showed optimal integration post-training. There were no significant effects of training for bimodal or vestibular-only heading estimates, nor standing-balance performance. These results indicate that it may be possible to improve unimodal (visual) heading perception using a multisensory (visual-vestibular) training paradigm. The results may also help to inform interventions targeting tasks for which effective self-motion perception is important.

Enhanced vection in older adults: Evidence for age-related effects in multisensory vection experiences.

The illusion of self-motion (vection) is a multisensory phenomenon elicited by visual, auditory, tactile, or other sensory cues. Aging is often associated with changes in sensory acuity, visual motion perception, and multisensory integration, processes which may influence vection perception. However, age-related differences in vection have received little study to date. Thus, the objective of the present study was to investigate age-related differences in vection during multisensory stimulation. Nineteen younger adults and 19 older adults were exposed to rotating visual, auditory, and tactile stimuli (separately or in combination) at a speed of 45°/s inside a VR laboratory inducing circular vection. The size of the field-of-view (FOV) was large (240°), medium (75°), small (30°), or contained no visuals. Vection intensity and duration were reported verbally after each trial. Overall, older adults experienced significantly stronger and longer vection compared to younger adults. Additionally, there were main effects of FOV and sensory cues, such that larger FOVs and the presence of auditory and tactile stimulation increased vection ratings for both age groups. These findings support the idea that vection is a multisensory experience that can be elicited by visual, auditory, and tactile stimuli and demonstrates these effects for the first time in older adults.

Age-related changes to vestibular heave and pitch perception and associations with postural control.

Falls are a common cause of injury in older adults (OAs), and age-related declines across the sensory systems are associated with increased falls risk. The vestibular system is particularly important for maintaining balance and supporting safe mobility, and aging has been associated with declines in vestibular end-organ functioning. However, few studies have examined potential age-related differences in vestibular perceptual sensitivities or their association with postural stability. Here we used an adaptive-staircase procedure to measure detection and discrimination thresholds in 19 healthy OAs and 18 healthy younger adults (YAs), by presenting participants with passive heave (linear up-and-down translations) and pitch (forward-backward tilt rotations) movements on a motion-platform in the dark. We also examined participants' postural stability under various standing-balance conditions. Associations among these postural measures and vestibular perceptual thresholds were further examined. Ultimately, OAs showed larger heave and pitch detection thresholds compared to YAs, and larger perceptual thresholds were associated with greater postural sway, but only in OAs. Overall, these results suggest that vestibular perceptual sensitivity declines with older age and that such declines are associated with poorer postural stability. Future studies could consider the potential applicability of these results in the development of screening tools for falls prevention in OAs.

Vestibular Perceptual Thresholds in Older Adults With and Without Age-related Hearing Loss.

OBJECTIVES: Older adults with age-related hearing loss (ARHL) are at greater risk of falling and have greater mobility problems than older adults with normal hearing (NH). The underlying cause of these associations remains unclear. One possible reason is that age-related declines in the vestibular system could parallel those observed in the auditory system within the same individuals. Here, we compare the sensitivity of vestibular perceptual abilities (psychophysics), vestibular end-organ functioning (vestibular evoked myogenic potentials and video head impulse tests), and standing balance (posturography) in healthy older adults with and without ARHL. DESIGN: A total of 46 community-dwelling older adults, 23 with ARHL and 23 with NH, were passively translated in heave (up and down) and rotated in pitch (tilted forward and backward) in the dark using a motion platform. Using an adaptive staircase psychophysical procedure, participants' heave and pitch detection and discrimination thresholds were determined. In a posturography task, participants' center of pressure (COP) path length was measured as they stood on a forceplate with eyes open and closed, on firm and compliant surfaces, with and without sound suppression. Baseline motor, cognitive, and sensory functioning, including vestibular end-organ function, were measured. RESULTS: Individuals with ARHL were less sensitive at discriminating pitch movements compared to older adults with NH. Poorer self-reported hearing abilities were also associated with poorer pitch discrimination. In addition to pitch discrimination thresholds, lower pitch detection thresholds were significantly associated with hearing loss in the low-frequency range. Less stable standing balance was significantly associated with poorer vestibular perceptual sensitivity. DISCUSSION: These findings provide evidence for an association between ARHL and reduced vestibular perceptual sensitivity.

Can Automated Vehicles Be Useful to Persons Living With Dementia? The Perspectives of Care Partners of People Living With Dementia.

BACKGROUND AND OBJECTIVES: Driving cessation is a complex challenge with significant emotional and health implications for people with dementia, which also affects their family care partners. Automated vehicles (AVs) could potentially be used to delay driving cessation and its adverse consequences for people with dementia and their care partners. Yet, no study to date has investigated whether care partners consider AVs to be potentially useful for people with dementia. RESEARCH DESIGN AND METHODS: This mixed-methods study assessed the views of 20 former or current family care partners of people with dementia on AV use by people with dementia. Specifically, questionnaires and semistructured interviews were used to examine care partners' acceptance of AV use by people with dementia and their views about the potential usefulness of AVs for people with dementia. RESULTS: The results demonstrated that care partners identified possible benefits of AV use by people with dementia such as their anticipated higher social participation. However, care partners also voiced major concerns around AV use by people with dementia and reported significantly lower levels of trust in and perceived safety of AVs if used by the person with dementia in their care compared to themselves. Care partners' concerns about AV use by people with dementia included concerns around the driving of people with dementia that AVs are not designed to address; concerns that are specific to AVs but are not relevant to the nonautomated driving of people with dementia; and concerns that arise from existing challenges around the nonautomated driving of people with dementia but may be exacerbated by AV use. DISCUSSION AND IMPLICATIONS: Findings from this study can inform future designs of AVs that are more accessible and useful for people with dementia.

Virtual Hand Illusion in younger and older adults.

INTRODUCTION: Embodiment involves experiencing ownership over our body and localizing it in space and is informed by multiple senses (visual, proprioceptive and tactile). Evidence suggests that embodiment and multisensory integration may change with older age. The Virtual Hand Illusion (VHI) has been used to investigate multisensory contributions to embodiment, but has never been evaluated in older adults. Spatio-temporal factors unique to virtual environments may differentially affect the embodied perceptions of older and younger adults. METHODS: Twenty-one younger (18-35 years) and 19 older (65+ years) adults completed the VHI paradigm. Body localization was measured at baseline and again, with subjective ownership ratings, following synchronous and asynchronous visual-tactile interactions. RESULTS: Higher ownership ratings were observed in the synchronous relative to the asynchronous condition, but no effects on localization/drift were found. No age differences were observed. Localization accuracy was biased in both age groups when the virtual hand was aligned with the real hand, indicating a visual mislocalization of the virtual hand. CONCLUSIONS: No age-related differences in the VHI were observed. Mislocalization of the hand in VR occurred for both groups, even when congruent and aligned; however, tactile feedback reduced localization biases. Our results expand the current understanding of age-related changes in multisensory embodiment within virtual environments.

Functional Consequences of Poor Binaural Hearing in Development: Evidence From Children With Unilateral Hearing Loss and Children Receiving Bilateral Cochlear Implants.

Poor binaural hearing in children was hypothesized to contribute to related cognitive and academic deficits. Children with unilateral hearing have normal hearing in one ear but no access to binaural cues. Their cognitive and academic deficits could be unique from children receiving bilateral cochlear implants (CIs) at young ages who have poor access to spectral cues and impaired binaural sensitivity. Both groups are at risk for vestibular/balance deficits which could further contribute to memory and learning challenges. Eighty-eight children (43 male:45 female, aged 9.89 ± 3.40 years), grouped by unilateral hearing loss (n = 20), bilateral CI (n = 32), and typically developing (n = 36), completed a battery of sensory, cognitive, and academic tests. Analyses revealed that children in both hearing loss groups had significantly poorer skills (accounting for age) on most tests than their normal hearing peers. Children with unilateral hearing loss had more asymmetric speech perception than children with bilateral CIs (p < .0001) but balance and language deficits (p = .0004, p < .0001, respectively) were similar in the two hearing loss groups (p > .05). Visuospatial memory deficits occurred in both hearing loss groups (p = .02) but more consistently across tests in children with unilateral hearing loss. Verbal memory was not significantly different than normal (p > .05). Principal component analyses revealed deficits in a main cluster of visuospatial memory, oral language, mathematics, and reading measures (explaining 46.8% data variability). The remaining components revealed clusters of self-reported hearing, balance and vestibular function, and speech perception deficits. The findings indicate significant developmental impacts of poor binaural hearing in children.

Multisensory Effects on Illusory Self-Motion (Vection): the Role of Visual, Auditory, and Tactile Cues.

A critical component to many immersive experiences in virtual reality (VR) is vection, defined as the illusion of self-motion. Traditionally, vection has been described as a visual phenomenon, but more recent research suggests that vection can be influenced by a variety of senses. The goal of the present study was to investigate the role of multisensory cues on vection by manipulating the availability of visual, auditory, and tactile stimuli in a VR setting. To achieve this, 24 adults (Mage = 25.04) were presented with a rotating stimulus aimed to induce circular vection. All participants completed trials that included a single sensory cue, a combination of two cues, or all three cues presented together. The size of the field of view (FOV) was manipulated across four levels (no-visuals, small, medium, full). Participants rated vection intensity and duration verbally after each trial. Results showed that all three sensory cues induced vection when presented in isolation, with visual cues eliciting the highest intensity and longest duration. The presence of auditory and tactile cues further increased vection intensity and duration compared to conditions where these cues were not presented. These findings support the idea that vection can be induced via multiple types of sensory inputs and can be intensified when multiple sensory inputs are combined.

Perceptions of Audio-Visual Impact Events in Younger and Older Adults.

Previous studies have examined whether audio-visual integration changes in older age, with some studies reporting age-related differences and others reporting no differences. Most studies have either used very basic and ambiguous stimuli (e.g., flash/beep) or highly contextualized, causally related stimuli (e.g., speech). However, few have used tasks that fall somewhere between the extremes of this continuum, such as those that include contextualized, causally related stimuli that are not speech-based; for example, audio-visual impact events. The present study used a paradigm requiring duration estimates and temporal order judgements (TOJ) of audio-visual impact events. Specifically, the Schutz-Lipscomb illusion, in which the perceived duration of a percussive tone is influenced by the length of the visual striking gesture, was examined in younger and older adults. Twenty-one younger and 21 older adult participants were presented with a visual point-light representation of a percussive impact event (i.e., a marimbist striking their instrument with a long or short gesture) combined with a percussive auditory tone. Participants completed a tone duration judgement task and a TOJ task. Five audio-visual temporal offsets (-400 to +400 ms) and five spatial offsets (from -90 to +90°) were randomly introduced. Results demonstrated that the strength of the illusion did not differ between older and younger adults and was not influenced by spatial or temporal offsets. Older adults showed an 'auditory first bias' when making TOJs. The current findings expand what is known about age-related differences in audio-visual integration by considering them in the context of impact-related events.

Virtual reality to promote wellbeing in persons with dementia: A scoping review.

Virtual Reality (VR) technologies have increasingly been considered potentially valuable tools in dementia-related research and could serve as non-pharmacological therapy to improve quality of life (QoL) and wellbeing for persons with dementia (PwD). In this scoping review, we summarize peer-reviewed articles published up to Jan-21, 2021, on the use of VR to promote wellbeing in PwD. Eighteen manuscripts (reporting on 19 studies) met the inclusion criteria, with a majority published in the past 2 years. Two reviewers independently coded the articles regarding A) intended clinical outcomes and effectiveness of the interventions, B) study sample (characteristics of the participants), C) intervention administration (by whom, what setting), D) experimental methods (design/instruments), and E) technical properties of the VR-systems (hardware/devices and software/content). Emotional outcomes were by far the most common objectives of the interventions, reported in seventeen (89.5%) of the included articles. Outcomes addressing social engagement and personhood in PwD have not been thoroughly explored using VR. Based on the positive impact of VR, future opportunities lie in identifying special features and customization of the hardware/software to afford the most benefit to different sub-groups of the target population. Overall, this review found that VR represents a promising tool for promoting wellbeing in PwD, with positive or neutral impact reported on emotional, social, and functional aspects of wellbeing.

Older adults' acceptance of fully automated vehicles: Effects of exposure, driving style, age, and driving conditions.

Automated vehicles are anticipated to have benefits for older adults in maintaining their mobility and autonomy. These anticipated benefits can only be realized if this technology is accepted and thus used by older adults. However, it remains unclear how certain factors affect older adults' acceptance of automated vehicles. This study investigated the extent to which older adults' acceptance of fully automated vehicles are affected by exposure to automated vehicle technology (pre- vs. post-exposure), driving style (manual style relative to automated style), driving conditions (clear, rain, traffic), and age. Thirty-six older adults (M = 73.25, SD = 5.96) completed non-automated (manual) and fully automated driving scenarios under different driving conditions in a high-fidelity driving simulator. The fully automated driving scenarios were designed to be reliably driven by the system in a conservative driving style. Driving conditions included clear daytime, rain, and high-traffic. Pre- and post-exposure to the simulated fully automated driving experience, participants rated their comfort level with fully automated vehicles (FAVs). Additionally, after each driving condition, participants answered a validated questionnaire on their acceptance of the simulated fully automated experience for each respective driving condition. Age and driving style were found to have a significant effect on older adults' acceptance of FAVs, with older age and greater dissimilarity of an individual's manual driving style from the FAV's driving style being associated with lower acceptance. The results suggest that if reliability of fully automated vehicles is ultimately ensured and is demonstrated to the older adults, their acceptance of fully automated vehicles is generally high, particularly if the FAV is operated in a style similar to their own.

Long term measures of vestibulo-ocular reflex function in high level male gymnasts and its possible role during context specific rotational tasks.

In a prior publication, we described a previously unknown eye movement phenomenon during the execution of actively performed multiaxial rotations in high level gymnasts. This phenomenon was consistently observed during the phase of fast free flight rotations and was marked by a prolonged and complete suppression of nystagmus and gaze stabilizing "environment referenced eye movements" (EREM; such as the vestibulo-ocular reflex, optokinetic reflex, smooth pursuit and others). Instead, these eye movements were coupled with intersegmental body movements. We have therefore called it "spinal motor-coupled eye movements" (SCEM) and have interpreted the phenomenon to likely be caused by anti-compensatory functions of more proprioceptive mediated reflexes and perhaps other mechanisms (e.g., top-down regulation as part of a motor plan) to effectively cope with a new-orientation in space, undisturbed by EREM functions. In the phase before landing, the phenomenon was replaced again by the known gaze-stabilizing EREM functions. The present study specifically evaluated long-term measures of vestibulo-ocular reflex functions (VOR) in high level gymnasts and controls during both passively driven monoaxial rotations and context-specific multiaxial somersault simulations in a vestibular lab. This approach provided further insights into the possible roles of adaptive or mental influences concerning the VOR function and how they are associated with the described phenomenon of SCEM. Results showed high inter-individual variability of VOR function in both gymnasts and controls, but no systematic adaptation of the VOR in gymnasts, neither compared to controls nor over a period of three years. This might generally support the hypothesis that the phenomenon of SCEM might indeed be driven more by proprioceptively mediated and situationally dominant eye movement functions than by adaptative processes of the VOR.