A taxonomy of cognitive tasks to evaluate cognitive-motor interference on spatiotemoporal gait parameters in older people: A systematic review and meta-analysis

Background: Walking in natural environments can be considered a dual-task (DT) scenario that requires increasing cognitive resources with advancing age. Previous reviews concluded that gait speed under DT conditions is equivalent to gait speed as a single task (ST) in the prediction of future falls in older people. However, without a clear taxonomy, these conclusions might be premature. The aim of this review is to use a taxonomy for classifying cognitive tasks of cognitive-motor interference (CMI) paradigms while walking to identify which task domains lead to more pronounced cognitive-motor decrements due to fall risk and concern about falling (CoF) in older people. Methods: A systematic literature research following PRISMA guidelines was conducted using MEDLINE, Psych-Info and EMBASE. Inclusion criteria were: Older people ≥60 years with a previous fall or CoF, use of a DT paradigm to discriminate fallers and non-fallers, straight overground walking, reported gait measurements during ST and DT conditions. A meta-analysis estimated the effect of DT costs for the cognitive task domain and spatiotemporal gait parameters. Results: N = 3737 studies were found within the databases. Nineteen studies were included (n = 14 for meta-analysis). Fallers and people with CoF showed reduced walking speed for ST and DT conditions. Effects of DT were examined for mental tracking tasks. The combined odds ratio (OR [95% confidence interval]) for fallers vs. non-fallers for ST was 3.13 [0.47, 5.80] with moderate heterogeneity (I 2 = 48%). For DT, the OR was 5.17 [2.42, 7.93] with low heterogeneity (I 2 = 37%). Comparing participants with and without CoF, the OR for ST was 12.41 [9.97, 14.84] with high heterogeneity (I 2 = 85%) and OR for mental tracking DT was 10.49 [7.58, 13.40] with moderate heterogeneity (I 2 = 51%). Conclusion: CMI was not significantly different between fallers and non-fallers or people with and without CoF; however, our taxonomy revealed a large variety of cognitive conditions and a higher number of studies using mental tracking tasks, which make it impossible to draw firm conclusions. Future studies should use a more standardised and ecologically valid approach when evaluating the validity of DT gait performance in the prediction of falls, CoF or other age-related conditions. Trial registration: This review was registered at Prospero with the ID: CRD42017068912

The effects of cognitive-motor training interventions on executive functions in older people: A systematic review and meta-analysis

Background: Ageing is associated with physical and cognitive decline, affecting independence and quality of life in older people. Recent studies show that in particular executive functions are important for daily-life function and mobility. This systematic review investigated the effectiveness of cognitive-motor training including exergaming on executive function (EF, set-shifting, working memory, inhibitory control) in healthy older people. Methods: An electronic database search for randomised controlled trials (RCT), controlled clinical trials (CCT) and parallel group trials was performed using MEDLINE, EMBASE, and PsychINFO following PRISMA guidelines. Inclusion criteria were: (1) community-dwelling participants 60 years without a medical condition or medical treatment, (2) reporting at least one cognitive-motor intervention while standing or walking, (3) use of dual-task interventions using traditional methods or modern technology to deliver a cognitive-motor task, (4) inclusion of at least one cognitive outcome. The PEDro scale was used for quality assessment. Results: A total of 1557 studies were retrieved, of which 25 studies were included in this review. Eleven studies used a technology-based dual-task intervention, while 14 trials conducted a general cognitive-motor training. The age range of the cohort was 69 to 87 years. The interventions demonstrated positive effects on global cognitive function [mean difference 0.6, 95% CI 0.29-0.90] and inhibitory control [mean difference 0.61, 95% CI 0.28-0.94]. Effects were heterogeneous (I2 range: 60-95) and did not remain after a sensitivity analysis. Processing speed and dual-task costs also improved, but meta-analysis was not possible. Conclusion: Cognitive-motor and technology-based interventions had a positive impact on some cognitive functions. Dual-task interventions led to improvements of domains related global cognitive functions and inhibitory control. Likewise, technology-based exergame interventions improved functions related to processing speed, attentional and inhibitory control. Training interventions with a certain level of exercise load such as progression in difficulty and task specificity were more effective to gain task-related adaptations on cognitive functions

Associations Between Planned Exercise, Walking, Incidental Physical Activity, and Habit Strength in Older People: A Cross-Sectional Study

Habits play an important role in physical activity (PA) engagement; however, these associations in older people are not well understood. The present study aimed to investigate the relationship between engagement in types of PA and their automaticity in older people, using an observational, cross-sectional design. Current hours engaged in planned exercise (excluding walking), planned walking, and incidental activities and the automaticity of those PA behaviors were measured in 127 community-dwelling Australians aged 65 years and older via an online questionnaire. After controlling for demographic and health factors (age, gender, education level, body mass index, history of falls, and anxiety and depression symptoms), higher automaticity scores were associated with more hours undertaking planned walking and incidental activity but not planned exercise. Although preliminary, these findings indicate that the role of habit in maintaining PA in older people may, therefore, differ depending on the type of activity

A Self-Guided Online Cognitive Behavioural Therapy to Reduce Fear of Falling in Older People: a Randomised Controlled Trial

Background: Traditional face-to-face cognitive behavioural therapy (CBT) has been successful at reducing fear of falling (FOF) in older people but can be labour-intensive and costly. Online CBT has been suggested as a cost-effective alternative but has not yet been tested in the context of FOF. This study evaluates the effectiveness of a readily available, self-guided and generalised online CBT program (myCompass) on reducing FOF in older people. Methods: Fifty community-dwelling older people with FOF received a paper-based health education program, and half were randomly assigned to receive three selected modules from myCompass for 6 weeks. The primary outcome was feared consequences of falling at 6 weeks. Secondary outcomes were concern about falling, balance confidence, activity avoidance, physical activity, exercise self-efficacy, health literacy and mental health at 6/26/52 weeks and falls incidence at 12 months. Results: All intervention participants completed at least 2-out-of-3 myCompass modules. There was a significant main effect of time on feared consequences of falling (Cohen’s f = 0.55). The group by time interactions for concern about falling (f = 0.28), stress (f = 0.26) and social support for health (health literacy) (f = 0.26) was also significant, favouring the control group. The overall attrition rate at 12 months was 24% (n = 12). Conclusion: The high program compliance and low attrition rate suggest that online CBT is feasible among older people. However, the myCompass program had no effect at reducing FOF in older people. A more targeted CBT program with a well-integrated psychoeducation module on FOF might be the solution to boost the therapeutic effects of a generalised CBT program at reducing FOF for older people

Primjena lociranja u relnom vremenu u zdravstvenoj njezi

This paper describes real-time locating technology and its possible use in health care. Real time locating may be applied in different segments of everyday life, including hospitals (medical equipment and devices, locating patients, and alarm in case of emergency), working environment (locating persons to control access to restricted areas or in case of fi re to see if anyone has been trapped inside the building), sports, logistics, retail trade, and offi ces. Tagged hospital equipment is easy to trace inside hospital premises and the system makes it possible to track patients and staff, and to redistribute work in particular wards.U ovom radu nastojao se opisati sustav lociranja u realnom vremenu. Dani su osnovni pojmovi, specifi kacije, kao i mogućnosti primjene u zdravstvenoj njezi. Lociranje u realnom vremenu nalazi primjenu u mnogim segmentima društvenog života kao što su bolnice (lociranje medicinskih naprava i pomagala unutar bolnice, lociranje bolesnika i alarmiranje u slučaju nužde), radno okruženje čovjeka (lociranje osoba u svrhu kontrole pristupa, tj. pristupa štićenom prostoru ili u slučaju požara čime se može utvrditi lokacija ljudi u zgradi te je li netko ostao zarobljen u zgradi), sport, logistika, maloprodaja, uredi. Označavanjem bolničkih osnovnih sredstava za rad omogućeno je njihovo praćenje i brže lociranje unutar bolničkih ustanova, također omogućuje se nadzor nad pacijentima, lociranje po odjelima i praćenje zauzetosti pojedinog odjela te preraspodjela rada pojedinog odjela

Extending Human Perception of Electromagnetic Radiation to the UV Region through Biologically Inspired Photochromic Fuzzy Logic (BIPFUL) Systems.

Photochromic Fuzzy Logic Systems have been designed that extend human visual perception into the UV region. The systems are founded on a detailed knowledge of the activation wavelengths and quantum yields of a series of thermally reversible photochromic compounds. By appropriate matching of the photochromic behaviour unique colour signatures are generated in response differing UV activation frequencies

Opportunities and limitations for functional agrobiodiversity in the European context

To counteract the negative effects of intensive agriculture there is increasing interest in approaches that reconcile agricultural production with the conservation and sustainable use of biodiversity and associated ecosystem services. Integration of functional agrobiodiversity (FAB) in agricultural systems holds promise to meet these challenging objectives, but requires the generation, transfer and implementation of tailor-made knowledge, and policy development. Currently various initiatives are undertaken across Europe to develop and assess the potential of biodiversity-based management practices by farmers, industry, researchers and governmental and non-governmental organizations. In this paper we show that the Convention on Biological Diversity and planned reforms in EU policy offer scope to further implement FAB concepts via legislation for biodiversity conservation, pesticide use, water quality, environmental protection and conservation of genetic resources. At the same time we observe that there are still impediments to the adoption of FAB approaches, including (i) translation of general knowledge to tailored, ready-to-use management practices, (ii) limited information on the effectiveness of FAB measures in terms of crop yield and quality, profitability, and reduction of agrochemical inputs, (iii) lack of appropriate financial accounting systems that allow fair accounting of the private investments and public benefits, and (iv) the implementation of FAB measures at the right spatial scales, which requires coordination among the various actors in a region. Current and new legislation may provide incentives to address these limitations and contribute to the further development and integration of FAB concepts in agricultural systems in Europe

Facilitators and barriers to physical activity and sport participation experienced by aboriginal and torres strait islander adults: A mixed method review

Physical activity has cultural significance and population health benefits. However, Aboriginal and Torres Strait Islander adults may experience challenges in participating in physical ac-tivity. This mixed methods systematic review aimed to synthetize existing evidence on facilitators and barriers for physical activity participation experienced by Aboriginal and Torres Strait Islander adults in Australia. The Joanna Briggs Institute methodology was used. A systematic search was undertaken of 11 databases and 14 grey literature websites during 2020. The included studies reported physical activity facilitators and barriers experienced by Aboriginal or Torres Strait Islander participants aged 18+ years, living in the community. Twenty‐seven studies met the inclusion crite-ria. Sixty‐two facilitators were identified: 23 individual, 18 interpersonal, 8 community/environ-mental and 13 policy/program facilitators. Additionally, 63 barriers were identified: 21 individual, 17 interpersonal, 15 community/environmental and 10 policy/program barriers. Prominent facilita-tors included support from family, friends, and program staff, and opportunities to connect with community or culture. Prominent barriers included a lack of transport, financial constraints, lack of time, and competing work, family or cultural commitments. Aboriginal and Torres Strait Islander adults experience multiple facilitators and barriers to physical activity participation. Strategies to increase participation should seek to enhance facilitators and address barriers, collaboratively with communities, with consideration to the local context

Facilitators and Barriers to Physical Activity and Sport Participation Experienced by Aboriginal and Torres Strait Islander Adults: A Mixed Method Review.

Physical activity has cultural significance and population health benefits. However, Aboriginal and Torres Strait Islander adults may experience challenges in participating in physical activity. This mixed methods systematic review aimed to synthetize existing evidence on facilitators and barriers for physical activity participation experienced by Aboriginal and Torres Strait Islander adults in Australia. The Joanna Briggs Institute methodology was used. A systematic search was undertaken of 11 databases and 14 grey literature websites during 2020. The included studies reported physical activity facilitators and barriers experienced by Aboriginal or Torres Strait Islander participants aged 18+ years, living in the community. Twenty-seven studies met the inclusion criteria. Sixty-two facilitators were identified: 23 individual, 18 interpersonal, 8 community/environmental and 13 policy/program facilitators. Additionally, 63 barriers were identified: 21 individual, 17 interpersonal, 15 community/environmental and 10 policy/program barriers. Prominent facilitators included support from family, friends, and program staff, and opportunities to connect with community or culture. Prominent barriers included a lack of transport, financial constraints, lack of time, and competing work, family or cultural commitments. Aboriginal and Torres Strait Islander adults experience multiple facilitators and barriers to physical activity participation. Strategies to increase participation should seek to enhance facilitators and address barriers, collaboratively with communities, with consideration to the local context

Dementia incidence, APOE genotype, and risk factors for cognitive decline in Aboriginal Australians

Background and Objectives Aboriginal Australians are disproportionately affected by dementia, with incidence in remote populations approximately double that of non-Indigenous populations. This study aimed to identify dementia incidence and risk factors in Aboriginal Australians residing in urban areas, which are currently unknown. Methods A population-based cohort of Aboriginal Australians ≥60 years of age was assessed at baseline and 6-year follow-up. Life-course risk factors (baseline) were examined for incident dementia or mild cognitive impairment (MCI) through logistic regression analyses; adjustments were made for age. APOE genotyping was available for 86 people. Results Data were included from 155 participants 60 to 86 years of age (mean 65.70 years, SD 5.65 years; 59 male). There were 16 incident dementia cases (age-standardized rate 35.97/1,000 person-years, 95% confidence interval [CI] 18.34–53.60) and 36 combined incident MCI and dementia cases. Older age (odds ratio [OR] 2.29, 95% CI 1.42–3.70), male sex (OR 4.14, 95% CI 1.60–10.77), unskilled work history (OR 5.09, 95% CI 1.95–13.26), polypharmacy (OR 3.11, 95% CI 1.17–8.28), and past smoking (OR 0.24, 95% CI 0.08–0.75) were associated with incident MCI/dementia in the final model. APOE e4 allele frequency was 24%; heterozygous or homozygous e4 was associated with incident MCI/dementia (bivariate OR 3.96, 95% CI 1.25–12.50). Discussion These findings provide evidence for higher dementia incidence in Aboriginal Australians from urban areas, where the majority of Aboriginal people reside. This study also sheds light on sociodemographic, health, and genetic factors associated with incident MCI/dementia at older ages in this population, which is critical for targeted prevention strategies