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老年人神经认知适应的多时间尺度、多方法视角。

A multi-timescale, multi-method perspective on older adult neurocognitive adaptability.

机构信息

Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada.

Department of Psychology, University of Victoria, Victoria, British Columbia, Canada.

出版信息

Clin Neuropsychol. 2020 May;34(4):643-677. doi: 10.1080/13854046.2020.1723706. Epub 2020 Feb 13.

Abstract

Ethical and economic values compel us to improve the screening, monitoring, and enhancement of older adult neurocognitive adaptability. Diverse contemporary theoretical and empirical perspectives highlight the multi-timescale, multi-mechanistic nature of neurocognitive adaptability. Still lacking are frameworks and methodologies that demonstrate this convergence to allow for new paradigms that harness the clinical utility of neurocognitive adaptability. We present a multi-method, multi-timescale analysis of neurocognitive adaptability in a group of healthy, community-dwelling older adults from the Victoria, British Columbia region. Each participant completed a 96-trial computerized cognitive flexibility task at 4 to 6 separate laboratory visits spanning about a month. This captured within-person changes at the within-occasion and across-occasion levels (timescales of seconds and days/weeks, respectively). We used standardized clinical assessments of cognitive reserve (i.e., estimated premorbid function) and conscientiousness (a personality dimension) as cross-sectional (time-invariant) predictors in multi-level linear regression to illustrate between-person differences in within-person cognitive performance trajectories. Reserve predicted cognitive performance differences at the timescale of seconds (within occasions) but did not relate to differences at the timescale of days/weeks (across occasions); in contrast, conscientiousness predicted cognitive performance differences at both timescales. Distinct processes operating within the same task (stimulus-classification vs. set-shifting) improved with practice at discrepant rates. Neurocognitive adaptability is underlain by multiple biopsychosocial mechanisms. Certain widely-used clinical indices (e.g., of reserve or conscientiousness) may estimate distinct types of neurocognitive adaptability relevant to maintaining functional independence into old age. Our methodology and theoretical framework assume that neurocognitive adaptability unfolds at multiple hierarchical scales of time.

摘要

伦理和经济价值迫使我们改进对老年人大脑认知适应性的筛选、监测和增强。各种当代理论和实证观点强调了大脑认知适应性的多时间尺度、多机制性质。仍然缺乏的是展示这种融合的框架和方法,以允许利用大脑认知适应性的临床实用性的新范式。我们提出了一种对不列颠哥伦比亚省维多利亚地区一组健康、社区居住的老年人的大脑认知适应性进行的多方法、多时间尺度分析。每位参与者在大约一个月的时间内,分 4 到 6 次实验室访问,完成了 96 次计算机化认知灵活性任务。这捕获了个体内的变化,包括在单次和多次出现的水平(分别为秒和天/周的时间尺度)。我们使用认知储备(即估计的前期功能)和尽责性(个性维度)的标准化临床评估作为横断面(时间不变)预测因子,在多层线性回归中,说明个体间差异对个体内认知表现轨迹的影响。储备预测了秒级(单次出现)的认知表现差异,但与天/周级(多次出现)的差异无关;相比之下,尽责性预测了两个时间尺度上的认知表现差异。在同一任务(刺激分类与定势转移)中运作的不同过程以不同的速度进行练习而得到改善。大脑认知适应性是由多个生物心理社会机制共同作用的结果。某些广泛使用的临床指标(例如储备或尽责性)可能会估计与保持老年时功能独立性相关的不同类型的大脑认知适应性。我们的方法和理论框架假设大脑认知适应性在多个时间层次尺度上展开。

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