The effects of a new immersive multidomain training on cognitive, dual-task and physical functions in older adults.

The aim of this study was to assess the potential of multidomain training using Immersive and Interactive Wall Exergames (I2WE) to improve the cognitive and physical functions of older adults. This new generation of exergames offers specific advantageous characteristics (e.g., immersion, virtual cognitive solicitation, high physical stimulation, complex motor skills, multiple social interactions) that could make I2WE an enjoyable multidomain training medium for older adults. A pilot study was set up with 34 participants (M = 69.91 years old). It used the pre-tests - training (3 months, 2 one-hour sessions per week for the 2 groups) - post-tests method to compare: a) the cognitive and the Dual-Task (DT) effects (primary outcomes), b) the physical effects and perceived pleasure (secondary outcomes) between an experimental group following an I2WE program (n = 19) to an active control group performing a Walking and Muscle-Strengthening (WMS) program (n = 15). While visuospatial short-term memory was improved for both groups, only I2WE training enhanced visuospatial working memory, inhibition, and DT. All physical functions, except upper body strength, were enhanced for the 2 groups. The perceived pleasure was higher for the I2WE group than the WMS group. The results of this first study have important clinical implications, showing that I2WE can optimize strategies to improve older adults' physical and cognitive health. Virtual and immersive cognitive stimulation combined with varied physical activity (i.e., aerobic, muscle-strengthening, complex motor skills) appear to be major assets of these new exergames. Moreover, the high level of perceived pleasure to I2WE makes it a promising tool for engaging older adults in sustained multidomain practice.

Wireless Lighting System: A New Tool for Assessing Cognitive Functions in the Elderly.

Studies on the effects of aging on cognition have been using the same cognitive tests for decades. A Wireless Lighting System (WLS) could be used to assess cognitive functions in a physically active situation, making the assessment of cognition less isolated and more ecological. This pilot study aimed to evaluate the potential of a WLS for assessing older adults' cognitive functions. It was set up with 15 young (M = 23.47 years old) and 18 older adults (M = 71.44 years old). Their performances were recorded on three WLS tests, designed with the Witty SEM system to assess four main cognitive functions (i.e., inhibition, flexibility, visuospatial short-term and working memory), as well as on three traditional (TRAD) tests (Spatial Span Test, Stroop Test, Trail Making Test). The results show a significant difference between the YOUNG and OLD groups on all WLS test measures (except for WLS flexibility), as well as on all TRAD measures. Additionally, for the OLD group, there were significant correlations between WLS and TRAD test results (r = -0.49 for two measures of inhibition to r = -0.80 for two other measures of inhibition), except for visuospatial short-term memory. However, there was no significant correlation for the YOUNG group (ρ = -0.27 for inhibition to r = 0.45 for visuospatial short-term memory). These WLS tests were valid for assessing the cognitive functions (i.e., flexibility, visuospatial short-term and working memory, inhibition) of older adults and were sensitive to aging.

Factors for optimizing intervention programs for cognition in older adults: the value of exergames.

This review presents factors that could optimize the effectiveness of an intervention program on cognitive health in older adults. Combined, multi-dimensional and interactive programs appear to be relevant. On one hand, for the characteristics to be implemented in the physical dimension of a program, multimodal interventions stimulating the aerobic pathway and muscle strengthening during the solicitation of gross motor activities, seem to be interesting. On the other hand, regarding the cognitive dimension of a program, complex and variable cognitive stimuli appear to hold the greatest promise for generating cognitive benefits and the broadest transfers to untrained tasks. The field of video games also brings interesting enrichment through the gamification of situations and the feeling of immersion. However, some gray areas remain to be clarified, notably the ideal response dose, the balance between physical and cognitive solicitation and the programs' customization.

The User Experience of an Immersive and Interactive Wall Exergame in Older Adults.

Exergames are promising options for modulating the effects of aging on physical and cognitive functions. A new-generation immersive and interactive wall exergame (I2WE) has emerged in recent years, offering users freedom of movement as well as greater and varied interactions with other players, the environment, and the system than traditional games (e.g., Wii™, Kinect). These features could improve the user experience (UX) and thus the engagement and benefits of the intervention for older people. The purpose of this study was to determine whether this kind of exergame could be an effective tool for multidomain training for the elderly. An exploratory study was conducted with 38 healthy older adults who tested a single exergame session to evaluate the UX and the perceived enjoyment, as well as the session's workload and intensity. The results show that I2WE generates moderate-to-high physical intensity, following recommendations for older people, while the perceived exertion is lower. Moreover, it creates a positive UX that correlates with high perceived enjoyment while producing a suitable session's workload. I2WE appears to be an effective tool to promote physical activity while concurrently stimulating cognition in older adults. The intrinsic characteristics (i.e., immersion, combined physical and cognitive activity, interactions, complex motor skills, playfulness, and variety of collective games) give this new type of exergame a promising future. Future studies should be conducted to investigate the effects of an I2WE program on the physical and cognitive functions of older adults.

Effect of the Level of Physical Activity on Prefrontal Cortex Hemodynamics in Older Adults During Single- and Dual-Task Walking.

The present study aimed to examine the impact of the level of physical activity on prefrontal cortex activation in older adults during single- and dual-task walking. Thirty physically inactive and 36 active older adults (60-85 years old) performed six 2-min tasks on a treadmill: two static cognitive tasks, two single-task walking tests, and two dual-task walking tests. Hemodynamics at the level of the prefrontal cortex were measured continuously using functional near-infrared spectroscopy to evaluate cortical activation. The perceived difficulty of the task, cognitive performance, and gait parameters were also measured. During the walking tasks, the level of prefrontal cortex activation, the perceived difficulty of the task, cognitive performance, and motor parameters were not significantly different between active and inactive older adults. This unchanged activation with physical activity was likely the consequence of a similar motor and cognitive load and cardiorespiratory fitness in both active and inactive older adults.

Effect of Exergaming on Physical Fitness, Functional Mobility, and Cognitive Functioning in Adults With Down Syndrome.

This study examined whether exergames could improve physical, functional, and cognitive functions in people with Down syndrome. Twelve adults with DS, aged over 35 (M = 50.35, SD = 7.45), were randomly assigned to a Wii-based program (n = 6) or a control group (n = 6), and completed physical (Chair Stand Test, 6-Minute Walk Test), functional (TUG, TUDS), and cognitive tests (Corsi, Barrage tests). The experimental group completed a 12-week Wii-based program. There was high intervention adherence and, compared with the control group, greater improvements were observed in the Wii-based exercise intervention group in physical fitness and functional outcomes (p < .05), with no changes in cognitive outcomes.

[Psychological impact of Wii-empowerment in hospitalized elderly patients who fall: pilot study]. / Impact psychologique de la Wii-habilitation chez le sujet âgé chuteur hospitalisé : étude pilote.

Falls have serious psychological consequences in senior citizens. The practice of Wii, «Wii-habilitation¼, among senior fallers hospitalized in follow-up care and rehabilitation, improves their quality of life, but without impacting their fear of falling and self-esteem.

Cognitive Training Game Versus Action Videogame: Effects on Cognitive Functions in Older Adults.

OBJECTIVE: The purpose of the study was to compare a cognitive training game, Kawashima Brain Training (KBT), and an action videogame, Super Mario Bros (SMB), in their effects on cognitive function in older adults. MATERIALS AND METHODS: Thirty-six older adults were randomly assigned to the KBT group, the SMB group, or the no-training no-contact control group. All participants completed several cognitive tests [matrix reasoning, Stroop, Trail Making Test, digit symbol substitution test (DSST), Corsi clock, spatial relation, and number comparison]. Then, participants in the game groups were instructed to play the videogame (KBT or SMB) for 1 hour, thrice per week, during 2 months, for a total training time of 24 hours. When the twenty-four 1-hour game sessions were complete, the three groups again completed the cognitive tests. RESULTS: Analysis of variances on each of the cognitive measures and Tukey's post hoc tests showed that the matrix reasoning change score was significantly greater in both game groups than in the control group. The Stroop test change was significantly greater in the KBT group than in control and SMB groups. The DSST, Corsi block test, spatial relations test, and number comparison test showed significantly greater change in the SMB group than in the control group with KBT intermediate. CONCLUSION: The scope of benefits of SMB training seems broader than those from the KBT program. The intrinsic characteristics of SMB and KBT games may well be partly responsible for these differences.

French validation of the modified-falls efficacy scale (M-FES Fr).

INTRODUCTION: Among the tools assessing fall related self-efficacy, the Modified-Falls Efficacy Scale (M-FES) seems to be a comprehensive and sensitive scale. However, no validated French version exists to this day. OBJECTIVE: This study aims to translate the M-FES and validate this French translation (M-FES Fr). METHOD: The validation steps used to translate and validate the M-FES Fr were i) forward - backward translation, ii) examination of the internal structure and reliability, iii) evaluation of the convergent validity. In this study, 310 French-speaking older adults (56 geriatric patients and 254 community-dwelling older adults) completed the M-FES Fr. Among the community-dwelling older adults, 67 fallers and 70 non-fallers were also asked to complete questionnaires related to variables such as health, fear of falling, and physical activity levels. RESULTS: A two-factor solution (indoor vs outdoor activities) was suggested, which accounted for 68.1% of the total variance. Reliability estimates for both factors were good (Cronbach α > 0.94, ICC > .93). Significant differences between geriatric patients and community-dwelling older adults and between fallers and non-fallers were highlighted. Furthermore, the M-FES Fr scores were significantly linked to various risk factors for falling. CONCLUSION: The M-FES Fr has psychometric properties which are similar to those found in the original version, including reliability and validity. This questionnaire will enable French-speaking researchers and health professionals to work with the same concepts as those used in other languages. Notably, the M-FES Fr could be used in the development and evaluation of intervention strategies in the prevention of falls.

Protective Role of Recent and Past Long-Term Physical Activity on Age-Related Cognitive Decline: The Moderating Effect of Sex.

This study aimed to investigate if the impact of both recent and long-term physical activity on age-related cognitive decline would be modified by sex. One-hundred thirty-five men (N = 67) and women (N = 68) aged 18 to 80 years completed the Modifiable Activity Questionnaire and the Historical Leisure Activity Questionnaire. A composite score of cognitive functions was computed from five experimental tasks. Hierarchical regression analyses performed to test the moderating effect of recent physical activity on age-cognition relationship had not revealed significant result regardless of sex. Conversely, past long-term physical activity was found to slow down the age-related cognitive decline among women (ß = 0.22, p = .03), but not men. The findings support a lifecourse approach in identifying determinants of cognitive aging and the importance of taking into account the moderating role of sex. This article presented potential explanations for these moderators and future avenues to explore.

Joint Attention is Slowed in Older Adults.

BACKGROUND/STUDY CONTEXT: The automatic propensity to orient to the location where other people are looking is the main way of establishing joint attention with others. Whereas joint attention has been mostly investigated with young adults, the present study examines age-related differences in the magnitude and time course of joint attention. METHODS: Forty-three community-dwelling seniors and 43 younger adults performed a visuospatial task. The procedures closely follow those of gaze-cueing tasks commonly used to investigate joint attention. RESULTS: The findings revealed that a gaze-cueing effect occurs for both younger and older adults, with an equivalent average magnitude but with different time courses. The effect peaks later in older adults. CONCLUSION: Age-related differences in joint attention could be linked to a more general cognitive slowing rather than to poorer basic social skills. The present study adds to the growing interest in gerontological research regarding social attention.

The braking force in walking: age-related differences and improvement in older adults with exergame training.

The purposes of this present research were, in the first study, to determine whether age impacts a measure of postural control (the braking force in walking) and, in a second study, to determine whether exergame training in physically-simulated sport activity would show transfer, increasing the braking force in walking and also improving balance assessed by clinical measures, functional fitness, and health-related quality of life in older adults. For the second study, the authors developed an active video game training program (using the Wii system) with a pretest-training-posttest design comparing an experimental group (24 1-hr sessions of training) with a control group. Participants completed a battery comprising balance (braking force in short and normal step conditions), functional fitness (Senior Fitness Test), and health-related quality of life (SF-36). Results show that 12 weeks of video game-based exercise program training improved the braking force in the normal step condition, along with the functional fitness of lower limb strength, cardiovascular endurance, and motor agility, as measured by the Senior Fitness Test. Only the global mental dimension of the SF-36 was sensitive to exergame practice. Exergames appear to be an effective way to train postural control in older adults. Because of the multimodal nature of the activity, exergames provide an effective tool for remediation of age-related problems.

Preserved spatial memory for reaching to remembered three-dimensional targets in aging.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Compared with the large literature on the impact of aging on spatial memory span, far fewer studies have examined the influence of aging on spatial memory processes required to reach a remembered target. This study assessed the ability of seniors to accurately reach to three-dimensional (3D) memorized targets in four conditions in which the memory delay and the attentional demands varied. METHODS: The accuracy and variability of reaching movements (3D absolute, 3D variable, and spatial component errors) were analyzed to evaluate the performance of 12 young adults aged 20 to 30 and 12 older adults aged 62 to 69 in the different delay conditions (short passive delay, long passive delay, long cognitive delay, and long spatial delay). Variance analyses were applied on each error measure as well as on kinematic features of the movements (movement time, deceleration time, and peak velocity). RESULTS: Results revealed that older participants were as capable as their younger counterpart to maintain target location in memory regardless of task complexity. CONCLUSION: Although memory deficits have been found in older adults in several previous studies, the current results support the idea that healthy aging does not produce a breakdown in all memory tasks. Hence, a specific spatial memory channel seems to remain unaffected in normal aging.

[The effects of video games on cognitive aging]. / Effets de la pratique des jeux vidéo sur le vieillissement cognitif.

Advancing age is associated with cognitive decline, which, however, remains a very heterogeneous phenomenon. Indeed, several extrinsic factors seem to modulate the effect of aging on cognition. Recently, several studies have provided evidence that the practice of video games could engender many benefits by favoring the maintenance of cognitive vitality in the elderly. This review of the literature aims to establish a precise inventory of the relations between the various types of video games and cognitive aging, including both sedentary video games (i.e., classics as well as brain training) and active video games (i.e., exergames). The largest benefits seem to be provided by exergames which combine game play with significant physical exercise. This article also tries to define the determinants of the training programs which could be responsible for the observed improvements.

Effects of interactive physical-activity video-game training on physical and cognitive function in older adults.

The purpose of the present study was to assess the potential of exergame training based on physically simulated sport play as a mode of physical activity that could have cognitive benefits for older adults. If exergame play has the cognitive benefits of conventional physical activity and also has the intrinsic attractiveness of video games, then it might be a very effective way to induce desirable lifestyle changes in older adults. To examine this issue, the authors developed an active video game training program using a pretest-training-posttest design comparing an experimental group (24 × 1 hr of training) with a control group without treatment. Participants completed a battery of neuropsychological tests, assessing executive control, visuospatial functions, and processing speed, to measure the cognitive impact of the program. They were also given a battery of functional fitness tests to measure the physical impact of the program. The trainees improved significantly in measures of game performance. They also improved significantly more than the control participants in measures of physical function and cognitive measures of executive control and processing speed, but not on visuospatial measures. It was encouraging to observe that, engagement in physically simulated sport games yielded benefits to cognitive and physical skills that are directly involved in functional abilities older adults need in everyday living (e.g., Hultsch, Hertzog, Small, & Dixon, 1999).

Role of age in relation between two kinds of abilities and performance in acquisition of new motor skill.

Better understanding of age-related differences in skilled performance was the focus of analyses of cognitive-performance scores-relationships in acquisition of a new motor skill. 31 younger adults and 33 older adults were tested on both a cognitive and a psychomotor test. Then, they were asked to learn a juggling task over 12 sessions of 20 min. Analysis indicated age-related differences in the rate of learning. Acquisition by the younger adult group was significantly faster than that by the older adult group. This difference was also reflected in the relationship of cognition and performance for the two age groups. Motor execution for the older adults seemed to require more psychomotor ability, especially at the end of the learning sessions, and was dependent on cognitive control. This trend is consistent with the perspective that cognitive predictors of performance are related to age.