Do older adults mistake the accelerator for the brake pedal?: Older adults employ greater prefrontal cortical activity during a bipedal/bimanual response-position selection task.

Successful aging depends upon maintaining executive functions, which enable flexible response coordination. Although flexible responses are required for both hands and feet, as in driving, few studies have examined executive functions and brain activity in older adults, in terms of foot responses. In this study, younger (mean age = 20.8) and older participants (mean age = 68.7) performed a newly developed bimanual/bipedal response-position selection compatibility task while we measured their brain activity using functional near-infrared spectroscopy. Participants had to press either a left or right button using either their left or right foot (or hand), as directed by a two-dimensional cue signal. They executed either a straight or diagonal press response that mimicked stepping on the accelerator or brake pedal in a car. Foot responses produced more errors, longer reaction times, and greater brain activation than hand responses. Greater brain activation in the left dorsolateral prefrontal cortex (BA 46) was observed in incongruent (i.e., diagonal) than in congruent (straight) trials for foot responses, but not for hand responses, suggesting that participants had difficulty executing a diagonal foot response (as braking in a car), but not a diagonal hand response. Older participants exhibited greater brain activation across the PFC than younger participants, indicating that older adults activate additional brain circuits to compensate for declining executive functions. We discuss potential relationships between declining executive functions of older adults and the frequent automobile accidents (i.e., missteps) in which they are involved.