No abstract

Our objective was to identify the physiological measures that are sensitive to assessing cognitive workload across the spectrum of cognitive impairments. Three database searches were conducted: PubMed, PsychINFO, and Web of Science. Studies from the last decade that used physiological measures of cognitive workload in older adults (mean age >65 years-old) were reviewed. The cognitive workload of healthy older individuals was compared with the cognitive workload of younger adults, patients with mild cognitive impairment (MCI), and patients with Alzheimer's diseases (AD). The most common measures of cognitive workload included: electroencephalography, magnetoencephalography, functional magnetic resonance imaging, pupillometry, and heart rate variability. These physiological measures consistently showed greater cognitive workload in healthy older adults compared to younger adults when performing the same task. The same was observed in patients with MCI compared to healthy older adults. Behavioral performance declined when the available cognitive resources became insufficient to cope with the cognitive demands of a task, such as in AD. These findings may have implications for clinical practice and future cognitive interventions.

Executive functions encompass various cognitive processes and are critical in novel or demanding driving situations. Our aim was to determine the role of impairments in specific executive functions (updating, flexibility, inhibition) on road performance in drivers with Parkinson's disease (PD), a condition commonly associated with early executive dysfunction. In this pilot study, 19 patients with mild to moderate PD and 21 healthy controls matched for age, education, and driving experience were tested using a neuropsychological battery assessing global cognitive abilities, updating (n-back task), flexibility (plus-minus task), and inhibition (Stroop test). Participants also underwent a 45-minute road test in which they were scored by a driving instructor and a second experimenter. To separate "at-risk" drivers from safe drivers, a composite driving indicator was calculated from the Test Ride for Investigating Practical Fitness to Drive score, the penalty score from the observation grid, and the number of safety interventions made by the driving instructor. Eight of the 40 drivers (all PD) were rated as "at risk." Measures of updating (the n-back task) and mental flexibility (the plus-minus task) predicted driving safety even after adjustment for group status, explaining 53% of the total variance. These 2 tests also discriminated between safe and "at-risk" drivers within the PD group. These findings, although preliminary, suggest that updating and mental flexibility are critical for safe driving in PD. Assessment batteries for driving fitness should probe different aspects of executive functions, specifically when evaluating drivers with PD.

Our results provide more insights into the specific impairments that influence different dimensions of on-road driving and may be used as a framework for targeted driving intervention programs in MS.

Objective Driving activity requires major involvement of executive functions. The main objective of our study was to determine whether mental flexibility and the updating of information in working memory are affected in drivers with mild to moderate Parkinson's disease (PD). Methods The study included 25 patients, aged 58e76, with mild to moderate PD and 25 healthy controls matched for age, sex and education, with an average mileage of over 3000 km/year. Neuropsychological tests were conducted to assess global cognitive abilities, to evaluate updating (via the n-back task), flexibility (via the pluseminus task) and information-processing speed (via the Stroop test). Three different scenarios were developed on a driving simulator. Participants were asked to recall road signs (updating task), indicate the shape or colour of road signs according to road side (flexibility task) and to brake at the same time as the car ahead (information-processing speed task) while driving.