Can Driving-Simulator Training Enhance Visual Attention, Cognition, and Physical Functioning in Older Adults?
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ABSTRACT:
SUBMITTER: Haeger M
PROVIDER: S-EPMC5821998 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objectives: Attention Restoration Theory (ART) suggests that walking or being in natural settings, as opposed to urban environments, benefits cognitive skills because it is less demanding on attentional resources. However, it is unclear whether the same occurs when the person is performing a complex task such as driving, although it is proven that driving through different road environments is associated with different levels of fatigue and may engage attention differently. The present study investigated whether exposure to rural vs. urban road environments while driving would affect attentional capacity in young people after the drive, in line with the classic ART paradigms. Methods: We asked 38 young participants to complete the Sustained Attention to Response Task (SART) before and after being exposed to a rural or urban road in a virtual reality environment while driving in a full vehicle immersive driving simulator. Changes in SART performance based on environmental exposure where explored in terms of target sensitivity, accuracy, reaction times, and inverse efficiency. We analyzed potential road type effects on driving speed and accuracy. Possible effects of driving on attention were tested by comparing the sample performance to that of a control group of 15 participants who did not drive and sat on the passenger seat instead. Results: Exposure to rural or urban road environments in the driving sample was not associated with any significant changes in attentional performance. The two exposure groups did not differ significantly in terms of driving behavior. Comparisons between the driving sample and the control group controlling for age indicated that participants who drove were more accurate but slower at the SART than those who were passengers. Conclusion: The present study does not support the hypothesis that a short drive in a natural setting may promote attention restoration as compared to an urban setting. Methodological considerations as well as recommendations for future research are discussed.
| S-EPMC6378321 | biostudies-literature
Project description:Memory, cognition, executive functioning, and spatial cognition loss are prevalent in the normal aging process, but these impairments are observed more extensively in individuals with dementia, specifically Alzheimer's disease. To improve the impaired functions, serious games targeting the lost functions are commonly developed and used in training programs. In this study, we designed a virtual reality driving simulator (VRDS) as a serious game with different difficulty levels for improving the spatial cognition; we evaluated it on 11 participants with different levels of dementia for two weeks, every day except weekends (10 sessions of practice in total) and 30 min/day. We assessed the participants' spatial cognition before and after the intervention by an independent assessment (the VR replica of Morris Water test) and also by their performance playing the VRDS during the intervention. We also assessed the participants' mood by a standard depression scale as well as their plausible experience of simulation sickness. The results showed significant improvement in Morris water test. The participants' normalized correct trajectory (to find the target) was improved significantly by 44.4% at post-intervention with respect to baseline. Furthermore, on average, the participants progressed to higher (more challenging) levels of the game, and their spatial learning score increased throughout the sessions. Their mood also showed improvement with respect to baseline. Overall, the results hold promise for the designed VRDS as a mood-lifting and enhancing spatial skills serious game for older adults if it is played regularly. Trial Registry name: Investigating the Effect of Training with a Virtual Reality Driving Simulator URL: https://clinicaltrials.gov/ct2/show/NCT04074655 Clinical Trials.gov ID: NCT04074655.
| S-EPMC8842416 | biostudies-literature
Project description:Preserving attention abilities is of great concern to older adults who are motivated to maintain their quality of life. Both cognitive and physical fitness interventions have been utilized in intervention studies to assess maintenance and enhancement of attention abilities in seniors, and a coupling of these approaches is a compelling strategy to buttress both cognitive and physical health in a time- and resource-effective manner. With this perspective, we created a closed-loop, motion-capture video game (Body-Brain Trainer: BBT) that adapts a player's cognitive and physical demands in an integrated approach, thus creating a personalized and cohesive experience across both domains. Older adults who engaged in two months of BBT improved on both physical fitness (measures of blood pressure and balance) and attention (behavioral and neural metrics of attention on a continuous performance task) outcome measures beyond that of an expectancy matched, active, placebo control group, with maintenance of improved attention performance evidenced 1 year later. Following training, the BBT group's improvement on the attention outcome measure exceeded performance levels attained by an untrained group of 20-year olds, and showed age-equilibration of a neural signature of attention shown to decline with age: midline frontal theta power. These findings highlight the potential benefits of an integrated, cognitive-physical, closed-loop training platform as a powerful tool for both cognitive and physical enhancement in older adults.
| S-EPMC9427998 | biostudies-literature
Project description:As the number of older drivers increases, concern has been raised about the potential safety implications. Flexibility, coordination, and speed of movement have been associated with older drivers' on road performance.To determine whether a multicomponent physical conditioning program targeted to axial and extremity flexibility, coordination, and speed of movement could improve driving performance among older drivers.Randomized controlled trial with blinded assignment and end point assessment. Participants randomized to intervention underwent graduated exercises; controls received home, environment safety modules.Drivers, 178, age > or = 70 years with physical, but without substantial visual (acuity 20/40 or better) or cognitive (Mini Mental State Examination score > or =24) impairments were recruited from clinics and community sources.On-road driving performance assessed by experienced evaluators in dual-brake equipped vehicle in urban, residential, and highway traffic. Performance rated three ways: (1) 36-item scale evaluating driving maneuvers and traffic situations; (2) evaluator's overall rating; and (3) critical errors committed. Driving performance reassessed at 3 months by evaluator blinded to treatment group.Least squares mean change in road test scores at 3 months compared to baseline was 2.43 points higher in intervention than control participants (P = .03). Intervention drivers committed 37% fewer critical errors (P = .08); there were no significant differences in evaluator's overall ratings (P = .29). No injuries were reported, and complaints of pain were rare.This safe, well-tolerated intervention maintained driving performance, while controls declined during the study period. Having interventions that can maintain or enhance driving performance may allow clinician-patient discussions about driving to adopt a more positive tone, rather than focusing on driving limitation or cessation.
| S-EPMC1852916 | biostudies-other
Project description:PurposeDrivers with homonymous hemianopia (HH) were previously found to have impaired detection of blind-side hazards, yet in many jurisdictions they may obtain a license. We evaluated whether oblique 57Δ peripheral prisms (p-prisms) and perceptual-motor training improved blind-side detection rates.MethodsPatients with HH (n = 11) wore p-prisms for 2 weeks and then received perceptual-motor training (six visits) detecting and touching stimuli in the prism-expanded vision. In a driving simulator, patients drove and pressed the horn upon detection of pedestrians who ran toward the roadway (26 from each side): (1) without p-prisms at baseline; (2) with p-prisms after 2 weeks acclimation but before training; (3) with p-prisms after training; and (4) 3 months later.ResultsP-prisms improved blind-side detection from 42% to 56%, which further improved after training to 72% (all P < 0.001). Blind-side timely responses (adequate time to have stopped) improved from 31% without to 44% with p-prisms (P < 0.001) and further improved with training to 55% (P = 0.02). At the 3-month follow-up, improvements from training were maintained for detection (65%; P = 0.02) but not timely responses (P = 0.725). There was wide between-subject variability in baseline detection performance and response to p-prisms. There were no negative effects of p-prisms on vehicle control or seeing-side performance.ConclusionsP-prisms improved detection with no negative effects, and training may provide additional benefit.Translational relevanceIn jurisdictions where people with HH are legally driving, these data aid in clinical decision making by providing evidence that p-prisms improve performance without negative effects.
| S-EPMC5772830 | biostudies-literature
Project description:Purpose(i) To assess how well contrast sensitivity (CS) predicts night-time hazard detection distance (a key component of night driving ability), in normally sighted older drivers, relative to a conventional measure of high contrast visual acuity (VA); (ii) To evaluate whether CS can be accurately quantified within a night driving simulator.Materials and methodsParticipants were 15 (five female) ophthalmologically healthy adults, aged 55-81 years. CS was measured in a driving simulator using Landolt Cs, presented under static or dynamic driving conditions, and with or without glare. In the dynamic driving conditions, the participant was asked to simultaneously maintain a (virtual) speed of 60 km/h on a country road. In the with glare conditions, two calibrated LED arrays, moved by cable robots, simulated the trajectories and luminance characteristics of the (low beam) headlights of an approaching car. For comparison, CS was also measured clinically (with and without glare) using a Optovist I instrument (Vistec Inc., Olching, Germany). Visual acuity (VA) thresholds were also assessed at high and low contrast using the Freiburg Visual Acuity Test (FrACT) under photopic conditions. As a measure of driving performance, median hazard detection distance (MHDD) was computed, in meters, across three kinds of simulated obstacles of varying contrast.ResultsContrast sensitivity and low contrast VA were both significantly associated with driving performance (both P < 0.01), whereas conventional high contrast acuity was not (P = 0.10). There was good correlation (P < 0.01) between CS measured in the driving simulator and a conventional clinical instrument (Optovist I). As expected, CS was shown to decrease in the presence of glare, in dynamic driving conditions, and as a function of age (all P < 0.01).ConclusionContrast sensitivity and low contrast VA predict night-time hazard detection ability in a manner that conventional high contrast VA does not. Either may therefore provide a useful metric for assessing fitness to drive at night, particularly in older individuals. CS measurements can be made within a driving simulator, and the data are in good agreement with conventional clinical methods (Optovist I).
| S-EPMC9373794 | biostudies-literature
Project description:OBJECTIVE:Physical functioning is closely associated with cognition. The current study assessed the impact of three cognitive training programs on objective measures of physical functioning across 5 years. METHOD:Older adults randomized to a processing speed ( n = 702), reasoning ( n = 694), or memory ( n = 703) training intervention were compared with those randomized to a no-contact control condition ( n = 698). Intention-to-treat (ITT) and treatment-received/dosage (time-varying number of training sessions) analyses were conducted. RESULTS:There were no transfer effects in the ITT analyses. Treatment-received models demonstrated that training sessions (i.e., higher dosage) across all intervention arms transferred to better maintained Digit Symbol Copy and Turn 360 performance relative to the control group. More reasoning training transferred to better grip strength. DISCUSSION:This is the first study to demonstrate differential longitudinal cognitive training transfer effects to three performance-based physical functioning measures. Future research should investigate mechanisms of far-transfer effects.
| S-EPMC5453841 | biostudies-literature
Project description:ObjectivesTo determine the effects of cognitive training on cognitive abilities and everyday function over 10 years.DesignTen-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control group.SettingSix U.S. cities.ParticipantsA volunteer sample of 2,832 persons (mean baseline age 73.6; 26% African American) living independently.InterventionTen training sessions for memory, reasoning, or speed of processing; four sessions of booster training 11 and 35 months after initial training.MeasurementsObjectively measured cognitive abilities and self-reported and performance-based measures of everyday function.ResultsParticipants in each intervention group reported less difficulty with instrumental activities of daily living (IADLs) (memory: effect size = 0.48, 99% confidence interval (CI) = 0.12-0.84; reasoning: effect size = 0.38, 99% CI = 0.02-0.74; speed of processing: effect size = 0.36, 99% CI = 0.01-0.72). At a mean age of 82, approximately 60% of trained participants, versus 50% of controls (P < .05), were at or above their baseline level of self-reported IADL function at 10 years. The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years (reasoning: effect size = 0.23, 99% CI = 0.09-0.38; speed of processing: effect size = 0.66, 99% CI = 0.43-0.88). Memory training effects were no longer maintained for memory performance. Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance (effect size = 0.21, 99% CI = 0.01-0.41) and the speed-of-processing intervention for speed-of-processing performance (effect size = 0.62, 99% CI = 0.31-0.93).ConclusionEach Advanced Cognitive Training for Independent and Vital Elderly cognitive intervention resulted in less decline in self-reported IADL compared with the control group. Reasoning and speed, but not memory, training resulted in improved targeted cognitive abilities for 10 years.
| S-EPMC4055506 | biostudies-literature
Project description:Face cognition is a crucial skill for social interaction and shows large individual differences in healthy adults, suggesting a possibility for improvement in some. We developed and tested specific training procedures for the accuracy of face memory and the speed of face cognition. Two groups each of 20 healthy middle-aged trainees practiced for 29 daily sessions of 15 minutes duration with different computerized home-based training procedures. In addition, 20 matched and 59 non-matched controls were included. Face cognition speed training enhanced performance during the training and transferred to the latent factor level as measured in a pre-post comparison. Persistence of the training effect was evidenced at the manifest level after three months. However, the training procedure influenced the speed of processing object stimuli to the same extent as face stimuli and therefore seems to have affected a more general ability of processing complex visual stimuli and not only faces. No effects of training on the accuracy of face memory were found. This study demonstrates that face-specific abilities may be hard to improve but also shows the plasticity of the speed of processing complex visual stimuli - for the first time in middle-aged, normal adults.
| S-EPMC3954557 | biostudies-literature
Project description:Fluid intelligence is important for successful functioning in the modern world, but much evidence suggests that fluid intelligence is largely immutable after childhood. Recently, however, researchers have reported gains in fluid intelligence after multiple sessions of adaptive working memory training in adults. The current study attempted to replicate and expand those results by administering a broad assessment of cognitive abilities and personality traits to young adults who underwent 20 sessions of an adaptive dual n-back working memory training program and comparing their post-training performance on those tests to a matched set of young adults who underwent 20 sessions of an adaptive attentional tracking program. Pre- and post-training measurements of fluid intelligence, standardized intelligence tests, speed of processing, reading skills, and other tests of working memory were assessed. Both training groups exhibited substantial and specific improvements on the trained tasks that persisted for at least 6 months post-training, but no transfer of improvement was observed to any of the non-trained measurements when compared to a third untrained group serving as a passive control. These findings fail to support the idea that adaptive working memory training in healthy young adults enhances working memory capacity in non-trained tasks, fluid intelligence, or other measures of cognitive abilities.
| S-EPMC3661602 | biostudies-literature