Cognitive benefits of the attentional vs exergame training in older adults.

OBJECTIVE: The present study aimed at comparing the effectiveness of an Attentional Computerized Cognitive Training and a commercial Exergame Training. METHODS: Eighty-four healthy older adults took part in the study. They were randomly assigned to one of the following conditions: Attentional Computerized Cognitive Training (ATT-CCT), Exergame Training (EXERG-T), or passive Control Group (CG). Participants assigned to the experimental groups underwent 8 laboratory-based sessions-lasting approximately 45 min each-of the respective training activity. A battery of cognitive tests was assessed before, after, and 3 months following the intervention phase. RESULTS: The results showed that just the ATT-CCT improved participants' performance, specifically within attention, processing speed, verbal learning and memory. While both intervention groups revealed improved memory self-perception and decreased self-reported absent-mindedness, only the benefits following the ATT-CCT proved to be stable over time. CONCLUSIONS: The results suggested that our ATT-CCT may be an effective tool for enhancing cognitive abilities in older healthy adults.

Psychophysiological stress influences temporal accuracy.

Distortions of duration perception are often observed in response to highly arousing stimuli, but the exact mechanisms that evoke these variations are still under debate. Here, we investigate the effect of induced physiological arousal on time perception. Thirty-eight university students (22.89 ± 2.5; 28 females) were tested with spontaneous finger-tapping tasks and a time bisection task (with stimuli between 300 and 900 ms). Before the time bisection task, half of the participants (STRESS group) performed a stress-inducing task, i.e., the Paced Auditory Serial Addition Test (PASAT), whereas the other participants (CONTROL group) performed a control task, the Paced Auditory Number Reading Task (PANRAT). The PASAT induced a greater heart rate, but not electrodermal, increase, as well as a more unpleasant and arousing state compared to the PANRAT. Moreover, although the two groups presented a similar performance at the finger-tapping tasks, participants in the STRESS group showed better temporal performance at the time bisection task (i.e., lower constant error) than the controls. These results indicate that psychophysiological stress may alter the subsequent perception of time.

Do I dislike what you dislike? Investigating the effect of disgust on time processing.

Time perception can be distorted by emotional stimuli. The present study aims to investigate the effect of disgust on time perception in young adults. Here, we report two experiments in which a time bisection task was used with intervals lasting 400 ms (short standard) to 1600 ms (long standard). In Experiment 1, temporal intervals were marked by neutral images or images from food (rotten, joyful), and facial (disgust, happy) categories. In Experiment 2, disgust-eliciting and neutral stimuli belonging to seven different domains were used: faces, food, animals, body products, injury/infections, death and hygiene. Results showed temporal overestimations when, compared to neutral conditions, disgusted faces (Experiments 1 and 2) and disgusting death and hygiene stimuli (Experiment 2) were used, and a temporal underestimation when images of rotten food (Experiment 1) were used. Results are discussed in terms of arousal-based and attention-based processes and showed that the degree of the emotional component influences time perception.

The role of time-monitoring behaviour in time-based prospective memory performance in younger and older adults.

Time-based prospective memory (TB-PM) is the ability to remember to perform an action at a specific moment in the future. Accurate TB-PM performance requires several cognitive processes that are known to decline in normal ageing. This study aimed to examine associations between TB-PM performance and executive functions and time perception in younger and older adults. TB-PM was assessed with the Virtual Week paradigm. Using a within-subjects experimental manipulation, participants performed TB-PM tasks both when a clock was in constant view and when it was hidden behind a button. Results showed that younger adults performed significantly better than older adults on all TB-PM task types, and checked the clock more often, and more strategically. Clock availability improved TB-PM performance in all participants. Correlational analyses showed that TB-PM accuracy was positively related to clock-checking frequency but unrelated to time perception. Relationships between executive functions and TB-PM differed across age groups as well as TB-PM task types. The findings suggest that different cognitive processes are required for different types of TB-PM tasks and in different ages. These results highlight the importance of considering TB-PM task parameters when investigating the role of cognitive processes in PM performance and their contribution to age-related PM decline.

Italian version and normative data of Addenbrooke's Cognitive Examination III.

ABSTRACTObjectives:Addenbrooke's Cognitive Examination III (ACE-III) is a brief cognitive screening tool to assess five cognitive domains: attention/orientation, verbal fluency, memory, language, and visuospatial abilities. This study aimed to provide normative data (for total score and subscale scores) of the Italian version of ACE-III for gender, age, and education. METHODS: A total of 574 healthy Italian participants (mean age 68.70 ± 9.65; mean education 9.15 ± 4.04) were recruited from the community and included in the study. Linear regression analysis was performed to evaluate the effects of age, gender, and education on the ACE-III total performance score. RESULTS: Age and education exerted a significant effect on total and subscale ACE-III scores, whereas gender was on attention/orientation, language, and visuospatial subscale scores. From the derived linear equation, correction grids to adjust raw scores and equivalent scores (ESs) with cut-off values were provided. CONCLUSIONS: The present study provided normative data, correction grids, and ESs for ACE-III in an Italian population.

Improving prospective memory performance with future event simulation in traumatic brain injury patients.

OBJECTIVE: Previous studies have shown that traumatic brain injury (TBI) patients have difficulties with prospective memory (PM). Considering that PM is closely linked to independent living it is of primary interest to develop strategies that can improve PM performance in TBI patients. METHOD: This study employed Virtual Week task as a measure of PM, and we included future event simulation to boost PM performance. Study 1 evaluated the efficacy of the strategy and investigated possible practice effects. Twenty-four healthy participants performed Virtual Week in a no strategy condition, and 24 healthy participants performed it in a mixed condition (no strategy - future event simulation). In Study 2, 18 TBI patients completed the mixed condition of Virtual Week and were compared with the 24 healthy controls who undertook the mixed condition of Virtual Week in Study 1. All participants also completed a neuropsychological evaluation to characterize the groups on level of cognitive functioning. RESULTS: Study 1 showed that participants in the future event simulation condition outperformed participants in the no strategy condition, and these results were not attributable to practice effects. Results of Study 2 showed that TBI patients performed PM tasks less accurately than controls, but that future event simulation can substantially reduce TBI-related deficits in PM performance. The future event simulation strategy also improved the controls' PM performance. CONCLUSIONS: These studies showed the value of future event simulation strategy in improving PM performance in healthy participants as well as in TBI patients. PRACTITIONER POINTS: TBI patients performed PM tasks less accurately than controls, confirming prospective memory impairment in these patients. Participants in the future event simulation condition out-performed participants in the no strategy condition. Future event simulation can substantially reduce TBI-related deficits in PM performance. Future event simulation strategy also improved the controls' PM performance.

Virtual Week: Translation and adaptation for the Italian population.

The present study adapted a computerised version of Virtual Week, a laboratory measure of prospective memory designed to simulate the kinds of prospective memory tasks encountered in daily life. In particular, this study aimed to translate and adapt Virtual Week for an Italian population. We collected data from 198 subjects that were divided into five groups based on age: young-young adults (20-29 years, n = 47), young adults (30-45 years, n = 32), middle-age adults (46-59 years, n = 32), young-old adults (60-69 years, n = 41), and old-old adults (70 years plus, n = 39). Results showed that PM performance was best in younger adults, relatively stable over middle adulthood and then decreased with age, with older adults performing the least accurately, in particular for the time-based condition. Results also demonstrated good reliability estimates across a range of ages and task types. Thus, the adaptation of Virtual Week into Italian appears to be a reliable measure of prospective memory for the Italian population.

Effects of Emotional Facial Expression on Time Perception in Patients with Parkinson's Disease.

Previous studies have demonstrated that emotional facial expressions alter temporal judgments. Moreover, while some studies conducted with Parkinson's disease (PD) patients suggest dysfunction in the recognition of emotional facial expression, others have shown a dysfunction in time perception. In the present study, we investigate the magnitude of temporal distortions caused by the presentation of emotional facial expressions (anger, shame, and neutral) in PD patients and controls. Twenty-five older adults with PD and 17 healthy older adults took part in the present study. PD patients were divided into two sub-groups, with and without mild cognitive impairment (MCI), based on their neuropsychological performance. Participants were tested with a time bisection task with standard intervals lasting 400 ms and 1600 ms. The effect of facial emotional stimuli on time perception was evident in all participants, yet the effect was greater for PD-MCI patients. Furthermore, PD-MCI patients were more likely to underestimate long and overestimate short temporal intervals than PD-non-MCI patients and controls. Temporal impairment in PD-MCI patients seem to be mainly caused by a memory dysfunction. (JINS, 2016, 22, 890-899).

Prospective memory performance in traumatic brain injury patients: a study of implementation intentions.

Traumatic brain injury (TBI) patients often present with prospective memory (PM) dysfunction. Forgetting to complete tasks may result in a loss of independence, limited employment prospects and anxiety, therefore, it is important to develop programs to improve PM performance in TBI patients. A strategy which may improve PM performance is implementation intentions. It involves making explicit plans specifying when, where and how one will perform a task in the future. In the present study, a group of 36 TBI patients and a group of 34 controls performed Virtual Week using either implementation intentions or no strategy. The results showed that the PM performance of TBI patients was less accurate than controls, in particular when the PM cue was time-based. No effect of implementation intentions was observed for TBI patients, however, controls improved their PM performance when the task was time-based. The findings suggest that strategies to improve PM in this clinical group are likely to be more complex than those that benefit healthy adults and may involve targeting phases of the PM process other than, or in addition to, the intention formation phase.

Heart rate variability helps tracking time more accurately.

Adequate temporal abilities are crucial for adaptive behavior. In time processing, variations in the rate of pulses' emission by the pacemaker are often reported to be an important cause of temporal errors. These variations are often associated with physiological changes, and recently it has also been proposed that physiological changes may not just vary the pulses' emission, but they can work as a timekeeper themselves. In the present study we further explore the relationship between temporal abilities with autonomic activity and interoceptive awareness in a group of thirty healthy young adults (mean age 24.18 years; SD=2.1). Using electrocardiogram, impedance cardiography and skin conductance measures, we assessed the relationship between the autonomic profile at rest and temporal abilities in two temporal tasks (time bisection and finger tapping tasks). Results showed that heart rate variability affects time perception. We observed that increased heart rate variability (HRV) was associated with higher temporal accuracy. More specifically, we found that higher vagal control was associated with lower error in producing 1-s tempo, whereas higher overall HRV was related with lower error (measured by the constant error) in the time bisection task. Our results support the idea that bodily signals may shape our perception of time.

Test-retest consistency of Virtual Week: A task to investigate prospective memory.

The present study reports test-retest consistency of Virtual Week, a well-known measure of prospective memory (PM) performance. PM is the memory associated with carrying out actions at a specific moment in the future. Patients with neurological disorders as well as healthy older adults often report PM dysfunctions that affect their everyday living. In Experiment 1, 19 younger and 20 older adults undertook the standard version of Virtual Week (version A). Older adults showed lower performance compared to younger participants. However, the discrepancy between groups was eliminated at retest. Experiment 2 was conducted to investigate if remembering of PM content determined the improvement observed in older adults at retest in Experiment 1. To this end we created a parallel version (version B) in which we varied the content of the PM actions. Fifty older adults were assigned to one of the two experimental conditions: Version A at test and version B at retest or vice versa (25 participants in each condition). Results showed no group differences in PM performance between version A and version B; moreover, no effect of test-retest was found. The study confirmed that Virtual Week is a reliable measure of PM performance and also provided a new parallel version that can be useful in clinical setting.

Monitoring behaviour in a time-based prospective memory task: the involvement of executive functions and time perception.

This study investigated time-based prospective memory (PM) performance in 76 younger and 76 older adults with a time-monitoring task in which participants were required to press a designated key every 5 minutes while watching a movie. Participants were assigned to two conditions, free and fixed monitoring. In free monitoring participants could check a clock when they wanted, but in fixed monitoring they were restricted a maximum of six times every 5 minutes. We also investigated the involvement of time perception, inhibition, and updating in time-based PM performance. We hypothesised that participants with inefficiencies in those three cognitive functions would have less strategic monitoring behaviour and would also be less accurate at the target time. In the free-monitoring condition older adults checked the clock more frequently than younger participants, but presented with a similar pattern of monitoring behaviour and increased their frequency of clock checking closer to the target time. In the fixed-monitoring condition younger participants checked the clock more frequently than older adults and showed a strategic pattern of monitoring. Older adults did not show strategic use of clock checking and their monitoring function remained unchanged. Differences in PM accuracy and monitoring behaviour are discussed according to different involvement of cognitive abilities.

A focus group study for the design of a web-based tool for improving problem-solving in older adults.

The development of easily accessible and usable social and cognitive enhancement trainings is becoming a priority to reduce the impact of aging on quality of life. Since most activities of daily living (e.g., making a meal) require problem-solving skills, problem-solving interventions could be used to improve and/or maintain functional abilities in aging to prolong independence. To design an effective problem-solving training and increase older adults' adherence to the training, this study examined older adults' perceptions of their challenges in activities of daily living, their skills and difficulties in using information technology (IT), and their motivations and expectations for participating in a web-based problem-solving training activity. Four focus groups (two in Italy and two in the Netherlands) were conducted with older adults aged between 65 and 84 years, a total of 27 participants. The data were analyzed using the Atlas.ti 8 software for the thematic analysis. The analysis identified five thematic areas: interests and activities, difficulties and concerns, experiences and motivations for training, expertise and resources, suggestions for the design of the new training. The results were used to develop a first prototype of a Shared, Web-based, Intelligent Flexible Thinking Training (SWIFT), adapted to future user needs. The participation of older adults in this design phase was critical to understanding their needs, motivations, and expectations regarding the implementation and use of a cognitive enhancement training.

Time-based prospective memory in severe traumatic brain injury patients: the involvement of executive functions and time perception.

Prospective memory (PM) is the ability to remember to perform a future action at a specified later time, which is investigated through the use of event-based and time-based tasks. Prior investigations have found that PM is impaired following traumatic brain injury (TBI). However, there is limited information regarding the cognitive functions that mediate TBI and PM performance. Thus, this study investigated time-based PM in TBI patients, and the relationship among time-based PM, time perception, and executive functions. To accomplish this objective, 18 severe TBI patients and 18 healthy matched controls performed a time-based PM task, a time reproduction task, and two executive functions (Stroop and n-back) tasks. While both groups increased their monitoring frequency close to the target time, TBI patients monitored more and were less accurate than healthy controls at the target time confirming the time-based PM dysfunction in these patients. Importantly, executive functions, particularly inhibition and updating abilities, were strongly related to time-based PM performance; both time perception and executive functions are involved in time-based prospective memory in controls, whereas, only executive functions appear to be involved in TBI time-based prospective memory performance.

Using Virtual Week to assess prospective memory in younger and older adults.

Prospective memory (PM) is the ability to perform future intention. Older adults often present dysfunctions in PM tasks and investigating the nature of their difficulties have critical implication for their independent living. Virtual Week is a computer based program that simulate real week activities. Participants also performed executive functions tasks to investigate which abilities are involved in PM. Virtual Week has shown to be suitable instrument to evaluate PM performance with important implications on assessment and rehabilitation of PM dysfunctions.

Comparing different tests to detect early manifestation of prospective memory decline in aging.

OBJECTIVE: Prospective memory (PM) is the ability to remember to perform future intentions. Previous studies have demonstrated that, compared to a younger cohort, healthy older adults have impairments in PM. Considering the importance of early detection of age-related PM decline, the present study aims to compare the performance of healthy older adults using three well-known PM tests commonly used in clinical settings. METHOD: In the present study, we tested 70 older adults (65-95 years old) using the Cambridge Prospective Memory Test (CAMPROMPT), the Memory for Intentions Screening Test (MIST) and the Royal Prince Alfred Prospective Memory Test (RPA-ProMem). In order to compare performance across tests and the interaction between age and cues, we performed a linear mixed model with random intercept and random slopes. Moreover, additional mixed models with random intercept were run for analyzing the additional information provided by MIST and RPA-ProMem regarding delay responses, response modality effects and type of errors committed. RESULTS: Our data showed a drop in PM performance as age increased detected by all three tests. Furthermore, CAMPROMPT was the most sensitive test to identify differences in PM for event-and time-based cues, at least for participants with 65-77 years old. When data were analyzed in term of delay responses, participants were more accurate for 2 min delay (MIST) and 30 in delay (RPA-ProMem). Participants were less accurate when response modality was "verbal" compared to "action" (MIST) and made more PM errors as age increased. CONCLUSIONS: Overall, the study provides important information regarding age-related PM decline and can help researchers as well as clinicians in deciding the preferred test to evaluate PM performance.

Attentional distractor interference may be diminished by concurrent working memory load in normal participants and traumatic brain injury patients.

A reduction in congruency effects under working memory (WM) load has been previously described using different attentional paradigms (e.g., Kim, Kim, & Chun, 2005; Smilek, Enns, Eastwood, & Merikle, 2006). One hypothesis is that different types of WM load have different effects on attentional selection, depending on whether a specific memory load demands resources in common with target or distractor processing. In particular, if information in WM is related to the distractors in the selective attention task, there is a reduction in distraction (Kim et al., 2005). However, although previous results seem to point to a decrease in interference under high WM load conditions (Kim et al., 2005), the lack of a neutral baseline for the congruency effects makes it difficult to differentiate between a decrease in interference or in facilitation. In the present work we included neutral trials in the task introduced by Kim et al. (2005) and tested normal participants and traumatic brain injury patients. Results support a reduction in the processing of distractors under WM load, at least for incongruent trials in both groups. Theoretical as well as applied implications are discussed.

Age-related changes in time production and reproduction tasks: Involvement of attention and working memory processes.

Several studies have reported age-related differences in time estimation, which have been attributed either to a slowing of the pacemaker rate with aging or to impaired attention and/or working resources in older adults. Here, we compared performance of young and older participants on time production/reproduction tasks and on working memory, divided attention, sustained attention and executive attention tasks. Results showed that relative to young participants, older adults significantly under-reproduced and tended to over-produce target durations. Neither attention nor working memory predicted time reproduction and production performance. Conversely, when temporal variability was considered, participants' temporal variability in time production tasks was exclusively accounted for by age, whereas variability in temporal reproduction was also explained by divided attention and working memory. Overall, our results extend previous investigations on timing abilities in the elderly and underscore the importance of divided attention and working memory in the maintenance of a stable representation of durations.

Lack of Temporal Impairment in Patients With Mild Cognitive Impairment.

In the present study, we investigate possible temporal impairment in patients with mild cognitive impairment (MCI) and the amount of temporal distortions caused by the presentation of emotional facial expressions (anger, shame, and neutral) in MCI patients and controls. Twelve older adults with MCI and 14 healthy older adults were enrolled in the present study. All participants underwent a complete neuropsychological evaluation. We used three timing tasks to tap temporal abilities, namely time bisection (standard intervals lasting 400 and 1600 ms), finger-tapping (free and 1 s), and simple reaction-time tasks. The stimuli used in the time bisection task were facial emotional stimuli expressing anger or shame to investigate a possible contribution of emotional information as previously observed in healthy adults. MCI patients showed temporal abilities comparable to controls. We observed an effect of facial emotional stimuli on time perception when data were analyzed in terms of proportion of long responses, and this result was mainly driven by the temporal overestimation when a facial expression of anger was presented in controls. Results seem to suggest that the severity of the cognitive dysfunction accounts more for subjective temporal impairment than a compromised internal clock.

Dissociating Explicit and Implicit Timing in Parkinson's Disease Patients: Evidence from Bisection and Foreperiod Tasks.

A consistent body of literature reported that Parkinson's disease (PD) is marked by severe deficits in temporal processing. However, the exact nature of timing problems in PD patients is still elusive. In particular, what remains unclear is whether the temporal dysfunction observed in PD patients regards explicit and/or implicit timing. Explicit timing tasks require participants to attend to the duration of the stimulus, whereas in implicit timing tasks no explicit instruction to process time is received but time still affects performance. In the present study, we investigated temporal ability in PD by comparing 20 PD participants and 20 control participants in both explicit and implicit timing tasks. Specifically, we used a time bisection task to investigate explicit timing and a foreperiod task for implicit timing. Moreover, this is the first study investigating sequential effects in PD participants. Results showed preserved temporal ability in PD participants in the implicit timing task only (i.e., normal foreperiod and sequential effects). By contrast, PD participants failed in the explicit timing task as they displayed shorter perceived durations and higher variability compared to controls. Overall, the dissociation reported here supports the idea that timing can be differentiated according to whether it is explicitly or implicitly processed, and that PD participants are selectively impaired in the explicit processing of time.