Reducing fall risk with combined motor and cognitive training in elderly fallers

Background. Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. Methods. In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition). Results. Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, p = 0.009) although to a limited extent (ES -0.25) restricted to the period after intervention. Conclusions. This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling.Peer ReviewedPostprint (published version

Utility of the MoCA for cognitive impairment screening in long-term psychosis patients

Cognitive impairment is a key feature in patients with psychotic disorders. The Montreal Cognitive Assessment (MoCA) is a brief tool that has been shown to be effective in identifying mild cognitive impairment and early dementia. This study explores the usefulness of this instrument to detect cognitive impairment in long-term psychotic disorders. One hundred-forty stabilized patients were re-evaluated more than 15 years after a First Episode of Psychosis (FEP). Patients were psychopathologically assessed, and the MoCA test and MATRICS Consensus Cognitive Battery (MCCB) were administered. Two cut-off scores for cognitive impairment using the MCCB were applied (T score <40 and < 30). Concurrent validation was found between the total scores of the MoCA and MCCB. We also found significant associations between 5 out of 7 MoCA subtests (visuospatial-executive, attention, language, abstraction and delayed recall) and MCCB subtests but not for the naming and orientation MoCA subtests. Receiver operating characteristic (ROC) analysis suggested a <25 cut-off for cognitive impairment instead of the original <26. Our results suggest that the MoCA test is a useful screening instrument for assessing cognitive impairment in psychotic patients and has some advantages over other available instruments, such as its ease-of-use and short administration time

PET and P300 Relationships in Early Alzheimer\u27s Disease

The P300 (P3) wave of the auditory brain event-related potential was investigated in patients with probable Alzheimer\u27s disease to determine whether P300 latency discriminated these patients from controls and whether prolonged P300 latency correlated with rates of brain glucose metabolism as measured by Positron Emission Tomography. P300 latency was prolonged by more than 1.5 standard deviations from age expectancy in 14 of 18 patients, but none of 17 controls. In these subjects P300 latency was shown to be inversely correlated with relative metabolic rates of parietal and, to a lesser extent, temporal and frontal association areas, but not with subcortical areas

The Mechanics of Embodiment: A Dialogue on Embodiment and Computational Modeling

Embodied theories are increasingly challenging traditional views of cognition by arguing that conceptual representations that constitute our knowledge are grounded in sensory and motor experiences, and processed at this sensorimotor level, rather than being represented and processed abstractly in an amodal conceptual system. Given the established empirical foundation, and the relatively underspecified theories to date, many researchers are extremely interested in embodied cognition but are clamouring for more mechanistic implementations. What is needed at this stage is a push toward explicit computational models that implement sensory-motor grounding as intrinsic to cognitive processes. In this article, six authors from varying backgrounds and approaches address issues concerning the construction of embodied computational models, and illustrate what they view as the critical current and next steps toward mechanistic theories of embodiment. The first part has the form of a dialogue between two fictional characters: Ernest, the �experimenter�, and Mary, the �computational modeller�. The dialogue consists of an interactive sequence of questions, requests for clarification, challenges, and (tentative) answers, and touches the most important aspects of grounded theories that should inform computational modeling and, conversely, the impact that computational modeling could have on embodied theories. The second part of the article discusses the most important open challenges for embodied computational modelling