Modifying visual cues for safer foot clearances during stair ascent in young and older adults

BackgroundCognitive and visual impairments are common in Parkinson’s disease (PD) and contribute to gait deficit and falls. To date, cognition and vision in gait in PD have been assessed separately. Impact of both functions (which we term ‘visuo-cognition’) on gait however is likely interactive and can be tested using visual sampling (specifically saccadic eye movements) to provide an online behavioural measure of performance. Although experiments using static paradigms show saccadic impairment in PD, few studies have quantified visual sampling during dynamic motor tasks such as gait.This article describes a protocol developed for testing visuo-cognition during gait in order to examine the: 1) independent roles of cognition and vision in gait in PD, 2) interaction between both functions, and 3) role of visuo-cognition in gait in PD.Methods Two groups of older adults (≥50 years old) were recruited; non-demented people with PD (n=60) and age-matched controls (n=40). Participants attended one session and a sub-group (n=25) attended two further sessions in order to establish mobile eye-tracker reliability. Participants walked in a gait laboratory under different attentional (single and dual task), environmental (walk straight, through a door and turning), and cueing (no visual cues and visual cues) conditions. Visual sampling was recorded using synchronised mobile eye-tracker and electrooculography systems, and gait was measured using 3D motion analysis.Discussion This exploratory study examined visuo-cognitive processes and their impact on gait in PD. Improved understanding of the influence of cognitive and visual functions on visual sampling during gait and gait in PD will assist in development of interventions to improve gait and reduce falls risk. This study will also help establish robust mobile eye-tracking methods in older adults and people with PD.

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Development and Psychometrics Test of Home Environment Assessment Checklist for Community-Dwelling Older Adults with Dementia

Journal of Alzheimer s Disease ◽

10.3233/jad-200241 ◽

2020 ◽

Vol 77 (4) ◽

pp. 1389-1396

Author(s):

Yi Wang ◽

Liyu Li ◽

Shuangyue Tian ◽

Jie Wu ◽

Zhiwen Wang

Keyword(s):

Older Adults ◽

Home Environment ◽

Visual Cues ◽

Reliability And Validity ◽

Living Environment ◽

Community Dwelling ◽

Rater Reliability ◽

Environment Assessment ◽

People With Dementia ◽

Community Dwelling Older Adults

Background: Home environment is a core domain in the care of community-dwelling older adults with dementia, but there is no suitable instrument to measure it in China. Objective: To develop and psychometrically test the home environment assessment checklist for community-dwelling older adults with dementia. Methods: A three-step process was performed to develop and test this instrument: 1) based on the evidence-based theory, the checklist was summarized as the main points of evidence from living environment settings among older adults with dementia, 2) the draft tool was assigned to an iterative process of evaluation by a panel of examiners consisting of experts from treatment, nursing and caring, people with dementia and their caregivers, 3) inter-rater reliability and internal consistency were calculated with a sample of 348 caregivers of the older adults with dementia. Results: The HEAC consisted of 71 items in domains addressing safety, stability and familiarity, visual cues, and sensory stimulation. Psychometric evaluation showed that this tool demonstrated sound reliability and validity. Content validity was 0.969 which was established by a panel of experts (n = 10). Inter-rater reliability of two researchers was 0.978, and 0.848 for researchers and caregivers. Test-retest reliability was excellent (ICC = 0.757–0.877) in community-dwelling older adults with dementia 2 week apart. Conclusion: The HEAC is a new tool to help collect the reliable information on the barriers and facilitators of home environment for community-dwelling older adults with dementia and to precipitate the home modification process to improve the quality of care for people with dementia and their caregivers in daily life.

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Influence of working memory and executive function on stair ascent and descent in young and older adults

Experimental Gerontology ◽

10.1016/j.exger.2018.02.022 ◽

2018 ◽

Vol 106 ◽

pp. 74-79 ◽

Cited By ~ 7

Author(s):

Florence Gaillardin ◽

Stéphane Baudry

Keyword(s):

Older Adults ◽

Working Memory ◽

Executive Function ◽

Stair Ascent

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Using Contextual and Visual Cues to Improve Sung Word Recognition in Hearing Aid Users

Journal of Music Therapy ◽

10.1093/jmt/thaa009 ◽

2020 ◽

Vol 57 (4) ◽

pp. 379-405

Author(s):

Lindsey A Wilhelm

Keyword(s):

Older Adults ◽

Word Recognition ◽

Visual Cues ◽

Hearing Aid ◽

Community Dwelling ◽

Auditory Stimuli ◽

Music Listening ◽

Contextual Cues ◽

Music Therapists

Abstract Older adults commonly experience hearing loss that negatively affects the quality of life and creates barriers to effective therapeutic interactions as well as music listening. Music therapists have the potential to address some needs of older adults, but the effectiveness of music interventions is dependent on the perception of spoken and musical stimuli. Nonauditory information, such as contextual (e.g., keywords, picture related to song) and visual cues (e.g., clear view of singer’s face), can improve speech perception. The purpose of this study was to examine the benefit of contextual and visual cues on sung word recognition in the presence of guitar accompaniment. The researcher tested 24 community-dwelling older adult hearing aid (HA) users recruited through a university HA clinic and laboratory under 3 study conditions: (a) auditory stimuli only, (b) auditory stimuli with contextual cues, and (c) auditory stimuli with visual cues. Both visual and contextual nonauditory cues benefited participants on sung word recognition. Participants’ music background and training were predictive of success without nonauditory cues, and visual cues provided greater benefit than contextual cues. Based on the results of this study, it is recommended that music therapists increase the accessibility of music interventions reliant upon lyric recognition through the incorporation of clear visual and contextual cues.

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Postural adjustment errors reveal deficits in inhibition during lateral step initiation in older adults

Journal of Neurophysiology ◽

10.1152/jn.00682.2012 ◽

2013 ◽

Vol 109 (2) ◽

pp. 415-428 ◽

Cited By ~ 26

Author(s):

Patrick J. Sparto ◽

Susan I. Fuhrman ◽

Mark S. Redfern ◽

J. Richard Jennings ◽

Subashan Perera ◽

...

Keyword(s):

Older Adults ◽

Visual Cues ◽

Motor Program ◽

Postural Adjustment ◽

Postural Adjustments ◽

Inhibitory Function ◽

Step Initiation ◽

Reaction Forces ◽

Vertical Ground Reaction Forces ◽

Step Responses

Postural dual-task studies have demonstrated effects of various executive function components on gait and postural control in older adults. The purpose of the study was to explore the role of inhibition during lateral step initiation. Forty older adults participated (range 70–94 yr). Subjects stepped to the left or right in response to congruous and incongruous visual cues that consisted of left and right arrows appearing on left or right sides of a monitor. The timing of postural adjustments was identified by inflection points in the vertical ground reaction forces (VGRF) measured separately under each foot. Step responses could be classified into preferred and nonpreferred step behavior based on the number of postural adjustments that were made. Delays in onset of the first postural adjustment (PA1) and liftoff (LO) of the step leg during preferred steps progressively increased among the simple, choice, congruous, and incongruous tasks, indicating interference in processing the relevant visuospatial cue. Incongruous cues induced subjects to make more postural adjustments than they typically would (i.e., nonpreferred steps), representing errors in selection of the appropriate motor program. During these nonpreferred steps, the onset of the PA1 was earlier than during the preferred steps, indicating a failure to inhibit an inappropriate initial postural adjustment. The functional consequence of the additional postural adjustments was a delay in the LO compared with steps in which they did not make an error. These results suggest that deficits in inhibitory function may detrimentally affect step decision processing, by delaying voluntary step responses.

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Visual cues and the handwriting of older adults: A kinematic analysis.

Psychology and Aging ◽

10.1037/0882-7974.11.3.521 ◽

1996 ◽

Vol 11 (3) ◽

pp. 521-526 ◽

Cited By ~ 18

Author(s):

Melissa J. Slavin ◽

James G. Phillips ◽

John L. Bradshaw

Keyword(s):

Older Adults ◽

Kinematic Analysis ◽

Visual Cues

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Essential amino acid supplementation on muscle function and stair ascent/descent following 10 days of bed rest in older adults

The FASEB Journal ◽

10.1096/fasebj.21.5.a337 ◽

2007 ◽

Vol 21 (5) ◽

Author(s):

Brock Symons ◽

Juan Lombeida ◽

Elizabeth Protas ◽

Patrick Kortebein ◽

Douglas Paddon‐Jones ◽

...

Keyword(s):

Older Adults ◽

Amino Acid ◽

Muscle Function ◽

Essential Amino Acid ◽

Bed Rest ◽

Amino Acid Supplementation ◽

Acid Supplementation ◽

Stair Ascent

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Technology Solutions for Everyday Barriers Among Deaf Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.1641 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 425-425

Author(s):

Lyndsie Koon ◽

Shraddha Shende ◽

Wendy Rogers ◽

Jenny Singleton ◽

Megan Bayles

Keyword(s):

Older Adults ◽

American Sign Language ◽

Visual Cues ◽

Future Technology ◽

Solution Strategies ◽

Everyday Activities ◽

Age Related ◽

Aging Populations ◽

Technology Solution ◽

Primary Form

Abstract American Sign Language (ASL) is the primary form of communication for approximately 250,000 people in the U.S. (Mitchell et al., 2006). As these individuals age, they may experience challenges in their everyday activities. For example, ASL users rely on visual cues, but have age-related change in vision. Moreover, ASL users may need to utilize technology to communicate with non-ASL users, but the technology may not be suitable/usable for older adults. We explored these issues in the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) study, wherein we interviewed Deaf older adults (N=60) in ASL, who provided insights into unique, everyday challenges they encounter. We will focus on the technology solution strategies they incorporate to address and overcome challenges with daily activities. Understanding how participants think about, adapt, and utilize different technologies can inform future technology design to successfully support diverse, aging populations.

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Examining the Effect of Age on Visual–Vestibular Self-Motion Perception Using a Driving Paradigm

Perception ◽

10.1177/0301006616675883 ◽

2016 ◽

Vol 46 (5) ◽

pp. 566-585 ◽

Cited By ~ 9

Author(s):

Robert Ramkhalawansingh ◽

Behrang Keshavarz ◽

Bruce Haycock ◽

Saba Shahab ◽

Jennifer L. Campos

Keyword(s):

Older Adults ◽

Motion Perception ◽

Multisensory Integration ◽

Visual Cues ◽

Lateral Position ◽

Control Group ◽

Younger Adults ◽

Age Related ◽

Vestibular Cues ◽

Self Motion

Previous psychophysical research has examined how younger adults and non-human primates integrate visual and vestibular cues to perceive self-motion. However, there is much to be learned about how multisensory self-motion perception changes with age, and how these changes affect performance on everyday tasks involving self-motion. Evidence suggests that older adults display heightened multisensory integration compared with younger adults; however, few previous studies have examined this for visual–vestibular integration. To explore age differences in the way that visual and vestibular cues contribute to self-motion perception, we had younger and older participants complete a basic driving task containing visual and vestibular cues. We compared their performance against a previously established control group that experienced visual cues alone. Performance measures included speed, speed variability, and lateral position. Vestibular inputs resulted in more precise speed control among older adults, but not younger adults, when traversing curves. Older adults demonstrated more variability in lateral position when vestibular inputs were available versus when they were absent. These observations align with previous evidence of age-related differences in multisensory integration and demonstrate that they may extend to visual–vestibular integration. These findings may have implications for vehicle and simulator design when considering older users.

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