Walking impairs cognitive performance among people with multiple sclerosis but not controls

People with multiple sclerosis (MS) complain of problems completing two tasks simultaneously; sometimes called ‘dual-tasking’ (DT). Previous research in DT among people with MS has focused on how adding a cognitive task interferes with gait and few have measured how adding a motor task could interfere with cognition. We aimed to determine the extent to which walking affects a concurrent working memory task in people with MS compared to healthy controls. We recruited MS participants (n = 13) and controls (n = 10) matched by age (±3 years), education (±3 years) and gender. Participants first completed the cognitive task (subtracting 7’s from the previous number) and then again while walking on an instrumented walkway. Although there were no baseline differences in cognition or walking between MS participants and controls, MS participants demonstrated a 52% decrease in number of correct answers during DT (p < 0.001). Mental Tracking Rate (% correct answers/min) correlated strongly with MS-related disability measured using the Expanded Disability Status Scale (EDSS; r(11) = −0.68, p < 0.01). We propose that compromised mental tracking during walking could be related to limited neural resource capacity and could be a potentially useful outcome measure to detect ecologically valid dual tasking impairments.     

Effort to reduce postural sway affects both cognitive and motor performances in individuals with Parkinson’s disease

ObjectivesTo assess the effects of voluntarily reducing postural sway on postural control and to determine the attention level needed to do so in healthy adults (n = 16, 65.9 ± 9.7) and persons with PD (n = 25, 65.8 ± 9.5 years). Tasks: quiet and still standing conditions with and without a category task. Cognitive performance, center of pressure (CoP) displacement variability (RMSCoP) and velocity (VCoP) were assessed in the anterior-posterior (AP) and medial-lateral (ML) directions.Controls showed larger RMSCoP (AP) and VCoP (AP and ML) during still versus quiet standing (p < 0.01), while the PD group demonstrated no changes. In the PD group, RMSCoP and VCoP (ML) increased in still standing when performed with the cognitive task (p < 0.05). In both groups, cognitive responses decreased in still standing (p < 0.05).In PD, attempting to reduce postural sway did not affect postural control under single task conditions, however ML CoP variability and velocity did increase as a dual task. In older adults, increased displacement and velocity in both AP and ML directions was observed during single, but not dual task conditions. Therefore standing still might not be an adequate postural strategy as it increases the attentional demand and affects motor performance, putting persons with PD at greater risk for falls.     

Investigation of factors impacting mobility and gait in Parkinson disease

Mobility and gait limitations are major issues for people with Parkinson disease (PD). Identification of factors that contribute to these impairments may inform treatment and intervention strategies. In this study we investigated factors that predict mobility and gait impairment in PD. Participants with mild to moderate PD and without dementia (n = 114) were tested in one session ‘off’ medication. Mobility measures included the 6-Minute Walk test and Timed-Up-and-Go. Gait velocity was collected in four conditions: forward preferred speed, forward dual task, forward fast as possible and backward walking. The predictors analyzed were age, gender, disease severity, balance, balance confidence, fall history, self-reported physical activity, and executive function. Multiple regression models were used to assess the relationships between predictors and outcomes. The predictors, in different combinations for each outcome measure, explained 55.7% to 66.9% of variability for mobility and 39.5% to 52.8% for gait velocity. Balance was the most relevant factor (explaining up to 54.1% of variance in mobility and up to 45.6% in gait velocity). Balance confidence contributed to a lesser extent (2.0% to 8.2% of variance) in all models. Age explained a small percentage of variance in mobility and gait velocity (up to 2.9%). Executive function explained 3.0% of variance during forward walking only. The strong predictive relationships between balance deficits and mobility and gait impairment suggest targeting balance deficits may be particularly important for improving mobility and gait in people with PD, regardless of an individual’s age, disease severity, fall history, or other demographic features.     

Coping with type 1 diabetes through emerging adulthood: Longitudinal associations with perceived control and haemoglobin A1c

Objective: This study, which is part of a larger longitudinal study focusing on the biopsychosocial functioning of emerging adults with type 1 diabetes, examined how perceived personal control, coping and HbA_1c relate to one another over time.

Design and main outcome measures: Emerging adults with type 1 diabetes (18–30 years old) participated in a two-wave longitudinal study spanning five years (N = 164 at Time 1). At both times, patients completed questionnaires on perceived control and coping (i.e. diabetes integration, avoidant coping and passive resignation). HbA_1c values were obtained from treating clinicians. We investigated the directionality of effects using cross-lagged path analysis.

Results: Higher HbA_1c values predicted relative decreases in diabetes integration and increases in avoidant coping five years later. Feeling less in control over diabetes predicted the use of passive coping over time. Passive coping predicted a relative decrease in perceived control five years later.

Conclusion: These findings indicate that tackling poor glycaemic control is not only important to avoid medical complications but also to prevent patients from resorting to more avoidant coping strategies. Furthermore, given the longitudinal interplay between perceived control and passive coping, it is important that intervention efforts include both cognitive and behavioural components to be effective.     

B2B commitment building in emerging markets: the case of Brazil

The research examines the suitability of relationship marketing paradigms to emerging markets (EMs) through the lens of communication, relationship benefits and commitment. Using the U.S. as a developed nation sample and Brazil as a proxy for EM countries like the BRIC nations, a B2B buyer–supplier commitment-building model is conceptualized and tested for context-specific boundaries. The study compares communication behaviors and relationship benefits along functional, psychological and social dimensions to discern the evaluation process and governance mechanisms influenced by an EM buyer’s institutional environment. Results showed that buyers from relation-based EMs like Brazil base their relationship commitment more on the psychological attributes of the partnership, while a buyer’s commitment-building process in rule-based, developed nations like the US is largely influenced by functional attributes.     

Everyday‐like memory for objects in ageing and Alzheimer's disease assessed in a visually complex environment: The role of executive functioning and episodic memory

To investigate everyday memory, more and more studies rely on virtual‐reality applications to bridge the gap between in situ approaches and laboratory settings. In this vein, the present study was designed to assess everyday‐like memory from the virtual reality‐based Human Object Memory for Everyday Scenes (HOMES) test (Sauzéon et al., 2012 , Exp. Psychol., 59, 99) in ageing and in Alzheimer's disease (AD). Two aims motivated this study: the first was to assess multiple processes of episodic memory (EM) functioning embedded within contexts closely related to real life in ageing and AD using the multi‐trial free‐recall paradigm, and the second aim was to evaluate the mediating effects of executive functioning (EF), EM, and subjective memory complaints (SMCs) on age differences in the HOMES measures and in AD. To this end, the HOMES test and neurocognitive tests of EF and EM were administered to 23 younger adults, 23 older adults, and 16 patients with AD. The results were: firstly, compared to young adults, elderly adults presented only free‐recall decline that almost disappeared in recognition condition whereas AD patients exhibited a poor clustering, learning, and recognition performance, and also a high amount of false recognition; secondly, age differences as well as AD related deficits on the HOMES test were mediated by both memory and EF measure while those observed on false memory indices were only mediated by EM measure; thirdly, the HOMES indices are related to SMCs even when episodic or EF measures are controlled. Overall, the results supported the fact that the VR‐based memory test is an appropriate device to capture age‐related differences as well as the AD effect with respect to both in situ and laboratory settings.     

Tool use in left brain damage and Alzheimer's disease: What about function and manipulation knowledge?

Tool use disorders are usually associated with difficulties in retrieving function and manipulation knowledge. Here, we investigate tool use (Real Tool Use, RTU), function (Functional Association, FA) and manipulation knowledge (Gesture Recognition, GR) in 17 left‐brain‐damaged (LBD) patients and 14 AD patients (Alzheimer disease). LBD group exhibited predicted deficit on RTU but not on FA and GR while AD patients showed deficits on GR and FA with preserved tool use skills. These findings question the role played by function and manipulation knowledge in actual tool use.     

Cardiovascular Disease in Elders: Is It Inevitable?

Cardiovascular disease is the major cause of death and disability in America. The burden of cardiovascular disease is higher in elders than in younger populations, presumably because of life-long exposure to risk factors such as hypertension, smoking, abnormal blood lipids, lack of exercise, and/or obesity. Many assume that it is too late to attempt to modify risk factors in elders because behavior is so difficult to change. The purpose of this article is to argue that cardiovascular risk factor modification is effective in elders and should be vigorously pursued for the good of individuals, families, communities, and societies.     

现代医学模式形成与疾病治疗

现代生物心理社会医学模式已经成为卫生界领导及广大医务人员的共识 ,并以此指导临床医疗实践。临床诊断正在增添新的内容 ,疾病治疗这个概念也拓宽了她的外延 ,人文科学在医学中越来越显示出她独特的不可替代的地位和作用 ,生物治疗、心理治疗、哲学治疗是未来的三大块治疗模式     

Against all odds – is a more differentiated view of personality development in emerging adulthood needed? The case of young apprentices

Personality development in emerging adults who do not attend college after high school has been largely overlooked so far. In this study, we investigated personality development in emerging German adults (N_T1 = 1,886, M_ageT1 = 18.01 years, 29% female) undergoing vocational education and training (VET). The trainees were assessed at the start of VET, 1.5 years later, and another 1.5 years after that, just before graduation. Longitudinal latent change score analyses were applied. Bivariate analyses investigated life satisfaction and job strain as social and work‐related aspects that are potentially reciprocally related to personality development. Mean‐level personality changes included increases in neuroticism and decreases in agreeableness and conscientiousness in the first interval. In the second interval, neuroticism decreased and conscientiousness increased. Simultaneously, trainees reported a gradual decrease in extraversion and openness across the 3‐year time span. Personality, especially agreeableness and conscientiousness, emerged as a stronger predictor of changes in job strain and life satisfaction than vice versa. For example, more agreeable and more conscientious trainees subsequently showed increases in life satisfaction. Trainees reporting higher job strain subsequently showed decreases in agreeableness. Trajectories of personality development partly support the maturity principle that has been established in many college student samples.