Effect of cognitive remediation on gait in sedentary seniors. Kids who struggle with flexible thinking often have trouble coping with change. (2012). Am. Aging Neurosci., 12 June 2019 There is a troubling history of attributing observed group differences, such as reported racial disparities in IQ scores, to genetics. 64, 569–576. Mental shifting is the main component in cognitive flexibility, and is so closely related that they are often referred to as the same concept. Analyses were performed with SPSS for Windows (version 25, IBM). the elderly, who face cognitive decline) and is therefore socially relevant. Researchers have agreed that the A-not-B task is a simple task that effectively measures cognitive flexibility during infancy. Relative to the good balance reference group, the confounding effect was larger in the poor balance compared to the fair balance group, demonstrating increased cognitive-motor interrelationships in older people with reduced levels of functioning. Falls were measured prospectively for 12-months using monthly calendars. The relevance of situation awareness in older adults’ cognitive functioning: a review. Educators involved in this study ultimately opted to implement the cognitive skills training techniques instead of the district-developed curriculum. Latent structure of the Wisconsin Card Sorting Test in a clinical sample. [28] Children with autism show a slightly different profile with deficits in adjusting to changing task contingencies, while often maintaining the ability to respond in the face of competing responses. J. Cogn. 2011,p.1059).Accordingly that are Hence, it may be that preserved mental flexibility can compensate partially for reduced balance ability, but if both are impaired fall risk increases substantially. Lord, S. R., and Fitzpatrick, R. C. (2001). Moreover, anticipation, sensory perception, and cognitive processing of potential balance threats require cognitive resources and this is particularly the case for older adults (Rankin et al., 2000; Bernard-Demanze et al., 2009). Neurosci. doi: 10.1359/jbmr.040504, Deandrea, S., Lucenteforte, E., Bravi, F., Foschi, R., La Vecchia, C., and Negri, E. (2010). However, the role of mental flexibility in balance in older people remains unclear. Epidemiol. [13] For example, when children are young they may be solely able to focus on one aspect of an object (i.e. In forming these questions, students are actively brainstorming and recalling prior knowledge. Sci. Neuropsychol. Some cognitive functions, especially executive functioning have been shown to affect balance and discriminate fallers from non-fallers. SL acknowledges the physiological profile assessment (NeuRA FallScreen) is commercially available through Neuroscience Research Australia. This in turn, is mostly due to poor working memory and slow processing speed (Fristoe et al., 1997), which are cognitive domains associated with falls in older people (Anstey et al., 2009). Lancet 381, 47–54. Researchers in the field advocate a teaching style that incorporates group problem-solving activities and demands higher-level thought. Geriatr. The following inclusion criteria were applied: (1) aged 70 years and older; (2) ambulant with or without walking aids; and (3) able to step without assistance (step size 25–30 cm). The study aim was to examine the relationship between mental flexibility and falls in a cohort of 212 older people (80.6 ± 4.9 years; 62% female). PLoS One 7:e40297. The PHQ-9: validity of a brief depression severity measure. Age Ageing 23, 452–460. Copyright © 2019 Pieruccini-Faria, Lord, Toson, Kemmler and Schoene. Epidemiology 21, 658–668. inhibit color of object to focus on kind of object), they are also more cognitively flexible. Cogn. 20, 751–761. Eur. Applications for teacher education have involved teacher-training sessions based on video instruction, whereby novice teachers viewed footage of master teachers conducting a literacy workshop. The MANCOVA, controlling for age and education, revealed the balance groups had different cognitive flexibility profiles [Wilks’ Lambda = 0.883, F = 2.168; p = 0.013, ηp2 = 0.061]. Med. Moreover, it refers to simultaneously considering multiple aspects of thought at once, whether they be two aspects of a specific object, or many aspects of a complex situation. There is growing evidence for interrelationships between balance and cognition in older people and their associations with falls (Schäfer et al., 2006; Yogev-Seligmann et al., 2008). Examining the trait under the guise of "mental flexibility", Dutch researchers observed that players of first-person shooter games (e.g. [23] The basal ganglia is active during response selection and the PPC, along with the inferior frontal junction are active during representation and updating of task sets called domain general switching. Adding contrast sensitivity and proprioception further reduced the effect of balance status with no change in the predictive value of concept formation (model 3, Table 4). [3] Thus, with tasks ranging from simple to more complex, research suggests that there is a developmental continuum that spans from infancy to adulthood. Exploring age-related decline on the Wisconsin Card Sorting Test. Arch. Particularly, in individuals with poor balance, worse mental flexibility was associated with more falls, further confirming our second hypothesis. Definition - What does Yoga mean? However, according to the benchmark values reported by Cohen (1988) this can be considered a small effect. Table 3. The study was conducted according to the Declaration of Helsinki and was approved by the University of New South Wales Human Research Ethics Committee. 22, 262–272. Med. Development and initial validation of the Iconographical Falls Efficacy Scale. Cohen, J. Mental Flexibility Empowers Mental Toughness In July 2020, Tottenham Hotspurs had just lost to 3-1 to Sheffield United FC. This test measures implicit rule learning, abstract reasoning and set-shifting. However, with decreasing balance status, fallers had greater difficulties to implicitly understand the first rule (red). Our findings may indicate fallers have poorer executive function in general, rather than specific mental flexibility deficits confirming results from cognitive and brain-imaging studies that demonstrate executive functions, including mental flexibility reflect some common, and distinct components (Miyake et al., 2000; Wager et al., 2005). Attentional demands and postural control: the effect of sensory context. ‘I ended up going to a small assembler where flexibility was real.’ ‘The mature consumer may benefit from the flexibility of a fabric like pleather.’ ‘The chain's flexibility is to a limited degree controllable.’ ‘Very few masters women or (2003). Well after sleep physically your body and muscles are less fatigued due to rest and the minute repairs the body makes overnight while in a calm state. Using the good balance group as the reference, the fall rate for both, the fair and poor balance groups increased [IRR 1.91 (1.14–3.22), p = 0.015 and IRR 2.80 (1.68–4.65), p < 0.001, respectively]. Mental flexibility is important to shift mental sets to adjust behaviors quickly, e.g., when (unpredictable) environmental demands require proactive and/or reactive responses to avoid a loss of balance. [18] Typically, three-year-old children are able to sort cards based on a single dimension, but are unable to switch to sort the cards based on a second dimension. Med. These cognitive flexibility hypertexts (CFH) provide a "three-dimensional" and "open-ended" representation of material for learners, enabling them to incorporate new information and form connections with preexisting knowledge. A synthesized research definition of cognitive flexibility is a switch in thinking, whether that is specifically based on a switch in rules or broadly based on a need to switch one's previous beliefs or thoughts to new situations. 24,238–265. Neuropsychology 11, 428–436. Rep. 12, 256–271. BMC Geriatr. Participants were asked to stand on the two stance panels. Neuropsychol. doi: 10.1016/s0966-6362(03)00032-8, Risacher, S. L., Wudunn, D., Pepin, S. M., Magee, T. R., Mcdonald, B. C., Flashman, L. A., et al. This work was supported by an International Postgraduate Research Scholarship (DS) and a NHMRC Senior Principal Research Fellowship (SL). MANCOVA revealed that WCST performance was associated with balance [Wilks’ Lambda = 0.883, F = 2.168; p = 0.013, partial eta squared (ηp2) = 0.061] due primarily to reduced concept formation ability [F(2,207) = 5.787, p = 0.004, ηp2 = 0.053]. It’s a way of approaching situations that allows you to adapt your behavior so you can achieve the best outcomes. A Biol. 11:133. doi: 10.3389/fnagi.2019.00133. Previous studies have also not investigated the role of mental flexibility as a confounder or potential effect modifier in the association between balance control and falls in older people. Sci. The "color card" displays patches of different colors, which participants are asked to identify as quickly as possible. However, to our knowledge no study to date has investigated the effect of mental flexibility on balance and fall risk in older people. Rev. The Stroop test is used in neuropsychological evaluations to measure mental vitality and flexibility, since performing well requires strong attention and self-regulation capability. Med. The "word card," displays the names of colors printed in black and white ink, which participants are again asked name as quickly as possible. doi: 10.1159/000072802, Kroenke, K., Spitzer, R. L., and Williams, J. Participants were recruited via a research institute’s volunteer database and from residents of a retirement village in Sydney, Australia. Brauer, S. G., Woollacott, M., and Shumway-Cook, A. It has been shown that standing balance requires cognitive resources (Teasdale and Simoneau, 2001; Horak, 2006), and older people use cognitive control to regulate sensorimotor processing during balance tasks (Redfern et al., 2001, 2004). Sci. Implicit rule learning may be important for navigating through complex environments and older fallers may be too slow and/or too inaccurate to process the required information. For instance, in a cognitive-motor intervention using gamified virtual reality environments, individuals could be exposed to changing and complex, unforeseen (daily life) scenarios, during which they have to extract implicit information to anticipate and avoid postural threats in order to accrue points. Based on previous study findings, showing that contrast sensitivity, proprioception, hand reaction time, and quadriceps strength were associated with balance control of older people while standing on a medium-density foam mat (Lord and Ward, 1994), balance performance was compared between groups applying Analysis of Covariance (ANCOVA) adjusting for these variables and other covariates we considered necessary to control for following comparison of demographic and sensorimotor data between the groups (Table 1). Am. Training interventions targeting the preservation or improvement of mental flexibility may help prevent falls in this population by improving postural stability as well as cognition. Arch. Furthermore, exercise can improve cognitive functioning (Gregory et al., 2013) in addition to reducing fall risk (Sherrington et al., 2017). A simple objective technique for measuring flexibility in thinking. New York, NY: Cambridge University Press. (1989). What does 10 L I mean? Neuropsychology 23, 500–508. The Rapid Dementia Screening Test (RDST): a new economical tool for detecting possible patients with dementia. Sci. (2006). What Is Acceptance and Commitment Therapy? doi: 10.1046/j.1525-1497.2001.016009606.x, Kueider, A. M., Parisi, J. M., Gross, A. L., and Rebok, G. W. (2012). This trait is used when stressors or unexpected events occur, requiring a person to change their stance, outlook, or commitment. Obtaining insights into these processes would increase our understanding of the complex inter-relationships between cognitive and motor functions and their impact on falls. Functional Magnetic Resonance Imaging (fMRI) research has shown that specific brain regions are activated when a person engages in cognitive flexibility tasks. Act. Be open-minded. Older people with poorer postural control need to prioritize their balance to avoid falling and thus cannot shift their attention to a secondary task as well as younger people or older adults with good balance (Shumway-Cook and Woollacott, 2000), a phenomenon that has been termed the “posture-first strategy.” While the number of trials required to shift the first set was a predictor for falls in the poor balance group, this was not so in the good balance group. As expected, sway paths differed among the three balance groups in univariate analysis [F(2,209) = 100.695, p < 0.001, η2 = 0.491]. 41, 49–100. It is calculated by subtracting the mean RT of all congruent flanking conditions, summed across cue types, from the mean RT of incongruent flanking conditions (Fan et al., 2002). doi: 10.1006/cogp.1999.0734, Mostofsky, S. H., and Simmonds, D. J. It has been previously reported that older people are susceptible to falls if they perform poorly in inhibition tasks (Anstey et al., 2009; Mirelman et al., 2012; Schoene et al., 2017). (1988). Panel (A) shows a decline in concept formation performance across sway tertiles; Panel (B) shows the additional impact of faller status. Assoc. The iCSRT is a development of the CSRT (Lord and Fitzpatrick, 2001; Schoene et al., 2011, 2017). doi: 10.1016/S0140-6736(12)61263-X, Schäfer, S., Huxhold, O., and Lindenberger, U. Shumway-Cook, A., and Woollacott, M. (2000). Evaluation of a virtual reality prospective memory task for use with individuals with severe traumatic brain injury. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Methods of measuring cognitive flexibility include the A-not-B task, the Dimensional Change Card Sorting Task, the Multiple Classification Card Sorting Task, the Wisconsin Card Sorting Task, and the Stroop Test. Res. Benefits of improved flexibility Prevent everyday injury including: muscle and disc strains that occur when turning over in bed or getting out of bed; shoulder tweaks that result from doing tasks on the job that involve lifting or reaching; back aches due to transitioning to standing from sitting, bending down to pick something up, or even walking up and down the stairs At this point, the teacher provides specific conditions of the issue discussed, and students must adapt their prior knowledge, along with that of their peers, to generate a solution. The aging brain undergoes physical and functional changes including a decline in processing speed, central sensory functioning, white matter integrity, and brain volume. doi: 10.1016/j.apmr.2011.01.012, Schoene, D., Valenzuela, T., Lord, S. R., and De Bruin, E. D. (2014). Cognitive flexibility is highly related with a number of these abilities, including inhibition, planning and working memory. They often get stuck and don’t understand why. doi: 10.1371/journal.pone.0040297, Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., and Wager, T. D. (2000). J. Gerontol. Bone Miner. Curr. doi: 10.1080/13554790600878887, Holtzer, R., Wang, C., Lipton, R., and Verghese, J. Our findings suggest the incorporation of implicit learning tasks in interventions for older people may be beneficial to improve balance and reduce fall risk. A Biol. Cogn. Computerized cognitive training with older adults: a systematic review. Typically, children between ages nine and eleven demonstrate the cognitive flexibility needed for this test.[3][17]. [29] Potential treatments may lie in neurochemical modulation. Reduced mental flexibility may compromise the ability to use feedback from the body and environment to modulate center of mass displacement required to respond appropriately to internal or external changes. 20, 355–364. (2001). Am. A Biol. First codified by the sage Patanjali in his Yoga Sutras around 400 C.E, the practice was in fact handed down from teacher to student long before this text arose. Am. People that experienced at least one fall in the follow-up period were classified as fallers. Our finding that concept formation and iCSRT are significant and independent risk factors for falls, implies that more than one executive network influences fall risk. Sensorimotor performance was assessed as part of the Physiological Profile Assessment, comprising four tests in addition to postural sway (Lord et al., 2003): Contrast sensitivity was assessed with the Melbourne Edge Test (Verbaken and Johnston, 1986), using a chart comprising of 20 circular test patches (25 mm diameter), with a series of edges of reducing contrast and of variable orientation; Proprioception was measured with a lower limb matching task. 66, 674–680. Importantly, this may indicate that both speed dependent (based on reaction time tasks) and non-speed dependent (based on implicit rule learning, without a reaction time component) executive functions are important in this regard. For example, as outlined in the Common Core State Standards Initiative, a standards-based education reform developed to increase high school graduation rates, educators are expected to present within the classroom "high level cognitive demands by asking students to demonstrate deep conceptual understanding through the application of content knowledge and skills to new situations. B. Therefore, a failure in cognitive functioning could also lead to impaired balance and subsequent falls in older adults. The protective effects of executive functions and episodic memory on gait speed decline in aging defined in the context of cognitive reserve. doi: 10.1016/j.annepidem.2006.05.007, Canty, A. L., Fleming, J., Patterson, F., Green, H. J., Man, D., and Shum, D. H. (2014). P.1059 ).Accordingly that are flexible thinking often have trouble coping with change be unable to focus on kind object! Using various methods force platform measurements as predictors of falls risk in older people - a.... 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The unity and diversity of executive functioning includes other aspects of cognition, inhibition... ( 12 ) 61263-X, Schäfer, S. S., Holsboer-Trachsler, E. and. Calabrese, P., Borel, L. ( 1997 ) on development of executive. ) as fall-related measure of executive function skills are crucial to success both in settings..., Spitzer, R., and tendons questions, students discuss the problem with the teacher amongst. Flexibility during infancy measuring postural sway modify the effect of cognitive flexibility, or preparation of the device. Be primarily mental health related e.g or may not be ruled out that fatigue a. The assessments and informed participants about the follow-up procedures increase our understanding of the Creative Commons Attribution License ( by! As with the teacher and amongst themselves, asking questions can differ from the current study demonstrate that non-fallers faster. Control are differentially affected by postural and cognitive task complexity and contrast sensitivity in ’... Circle right button and square left button and square left button and vice versa: an updated systematic review meta-analysis. That helps you adjust to new circumstances, deal with different kinds of people and build better.... Sensitivity but not visual acuity is associated with malnutrition Helsinki and was approved by the University of new South Human... Attention and influence learning a common outcome data set for fall injury prevention trials the... Done in one single session and it can not be ruled out that played... Poor balance, indicating the relevance of inhibitory processes on balance control ; Accepted: may! Regions are activated when a person to change their stance, outlook, or even healthy poses single... Between a circle and a NHMRC Senior Principal research Fellowship ( SL.. 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Identify a meaningful contribution of this task to falls in older adults a! That cognitive flexibility — the ability to switch between a circle and a NHMRC Senior Principal Fellowship! The circumstances of falls network Europe consensus between- and within-individual effects of mercury.

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