The interplay between cognitive and motor functioning in healthy older adults: findings from dual-task studies and suggestions for intervention

Reaching late adulthood is accompanied by losses in physical and mental resources, but lifestyle choices seem to have a considerable influence on the aging trajectory. This review deals with the interplay of cognitive and motor functioning in old age, focusing on two different lines of research, namely (a) dual-task studies requiring participants to perform a cognitive and a motor task simultaneously, and (b) intervention studies investigating whether increases in physical fitness also lead to improvements in cognitive performance. Dual-task studies indicate that healthy older adults show greater performance reductions in both domains than young adults when performing a cognitive and a motor task simultaneously. In addition, older adults often tend to protect their motor functioning at the expense of the cognitive task when the situation involves a threat to balance. This can be considered an adaptive behavior, since fall-related injuries can have severe consequences. Fitness intervention studies which increased the aerobic fitness of previously sedentary older adults have demonstrated impressive performance improvements in the cognitive domain, especially for tasks involving executive control processes. These findings are interesting in light of cognitive intervention studies, which often fail to find significant transfer effects to tasks that have not been trained directly. The authors argue that future research should compare the effects of cognitive and aerobic fitness interventions in older adults, and they present a study design in which cognition and fitness are trained sequentially as well as simultaneously. Finally, methodological issues involved in this type of research and potential applications for applied settings are discussed

Readiness to change is a predictor of reduced substance use involvement: Findings from a randomized controlled trial of patients attending South African emergency departments

Background: This study examines whether readiness to change is a predictor of substance use outcomes and explores factors associated with RTC substance use among patients at South African emergency departments. Methods: We use data from participants enrolled into a randomized controlled trial of a brief substance use intervention conducted in three emergency departments in Cape Town, South Africa. Results: In adjusted analyses, the SOCRATES "Recognition" (B = 11.6; 95 % CI = 6.2-17.0) and "Taking Steps" score (B = -9.5; 95 % CI = -15.5- -3.5) as well as alcohol problems (B = 4.4; 95 % CI = 0.9-7.9) predicted change in substance use involvement at 3 month follow-up. Severity of depression (B = 0.2; 95 % CI = 0.1-0.3), methamphetamine use (B = 3.4; 95 % CI = 0.5- 6.3) and substance-related injury (B = 1.9; 95 % CI = 0.6-3.2) were associated with greater recognition of the need for change. Depression (B = 0.1; 95 % CI = 0.04 -0.1) and methamphetamine use (B = 2.3; 95 % CI = 0.1 -4.2) were also associated with more ambivalence about whether to change. Participants who presented with an injury that was preceded by substance use were less likely to be taking steps to reduce their substance use compared to individuals who did not (B = -1.7; 95 % CI = -5.0- -0.6). Conclusion: Findings suggest that brief interventions for this population should include a strong focus on building readiness to change substance use through motivational enhancement strategies. Findings also suggest that providing additional support to individuals with depression may enhance intervention outcomes. Trial registration: This trial registered with the Pan African Clinical Trial Registry ( PACTR201308000591418 ) on 14/07/2013