Age-Related Changes in the Allocation of Vertical Attention

Mańkowska, Aleksandra; Heilman, Kenneth M.; Harciarek, Michał

doi:10.1017/s1355617718000620

Cited by 15 publications

(15 citation statements)

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“…Total clock drawing time to command, for example, associates with numerous cognitive domains [16]. Given the many cognitive domains involved in drawing a clock to command, it may be that the command condition can identify impairment in any cognitive domain, while individuals who show The graphomotor variables of hour hand distance from center and ideal digit placement difference are, theoretically, more sensitive to neurodegenerative changes within the dorsal attentional stream, as with aging there is atrophy of the dorsal stream which may lead to an upward attentional bias [31,32]. Of these two variables, hour hand distance from center showed potential value for predicting length of stay.…”

Section: Discussionmentioning

confidence: 99%

“… Hour hand distance from center: distance from the inner end of the hour hand to the center of the clock face (millimeters). We extracted this variable based on prior research demonstrating increased upward attentional bias with aging [ 31 , 32 ]. It has been posited that the age-related reductions in the dorsal attention stream, mediated by the parietal lobe, may be responsible for allocating downward attention [ 31 , 32 ].…”

Section: Methodsmentioning

confidence: 99%

“…We extracted this variable based on prior research demonstrating increased upward attentional bias with aging [ 31 , 32 ]. It has been posited that the age-related reductions in the dorsal attention stream, mediated by the parietal lobe, may be responsible for allocating downward attention [ 31 , 32 ]. With aging there is degradation of this dorsal stream, inducing an upward attentional bias [ 31 , 32 ].…”

Section: Methodsmentioning

confidence: 99%

“…It has been posited that the age-related reductions in the dorsal attention stream, mediated by the parietal lobe, may be responsible for allocating downward attention [ 31 , 32 ]. With aging there is degradation of this dorsal stream, inducing an upward attentional bias [ 31 , 32 ]. Therefore, when drawing a clock, it is possible that older adults with even subtle changes in visuospatial and planning abilities may deviate when determining the center of the clock (the central axis of the hour and minute hands).…”

Section: Methodsmentioning

confidence: 99%

“…Although previous research has demonstrated CDT copy acquired from traditional hand-scoring methods significantly predicted length of stay in older adults undergoing elective surgery [ 14 ], the current investigation will be the first to address the question with digital assessment technology. Given that individuals with TAVR have cerebrovascular disease [ 28 ] which associates with executive and graphomotor processing speed limitations [ 29 , 30 ], we a-priori explored the predictive value of CDT total clock drawing time [ 24 ] and key graphomotor metrics assessing visual attention and planning [ 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Proof of concept: digital clock drawing behaviors prior to transcatheter aortic valve replacement may predict length of hospital stay and cost of care

Wiggins

Dion

Formanski

et al. 2021

Exploration of Medicine

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Aims: Reduced pre-operative cognitive functioning in older adults is a risk factor for postoperative complications, but it is unknown if preoperative digitally-acquired clock drawing test (CDT) cognitive screening variables, which allow for more nuanced examination of patient performance, may predict lengthier hospital stay and greater cost of hospital care. This issue is particularly relevant for older adults undergoing transcatheter aortic valve replacement (TAVR), as this surgical procedure is chosen for intermediate-risk older adults needing aortic replacement. This proof of concept research explored if specific latency and graphomotor variables indicative of planning from digitally-acquired command and copy clock drawing would predict post-TAVR duration and cost of hospitalization, over and above age, education, American Society of Anesthesiologists (ASA) physical status classification score, and frailty. Methods: Form January 2018 to December 2019, 162 out of 190 individuals electing TAVR completed digital clock drawing as part of a hospital wide cognitive screening program. Separate hierarchical regressions were computed for the command and copy conditions of the CDT and assessed how a-priori selected clock drawing metrics (total time to completion, ideal digit placement difference, and hour hand distance from center; included within the same block) incrementally predicted outcome, as measured by R2 change significance values. Results: Above and beyond age, education, ASA physical status classification score, and frailty, only digitally-acquired CDT copy performance explained significant variance for length of hospital stay (9.5%) and cost of care (8.9%). Conclusions: Digital variables from clock copy condition provided predictive value over common demographic and comorbidity variables. We hypothesize this is due to the sensitivity of the copy condition to executive dysfunction, as has been shown in previous studies for subtypes of cognitive impairment. Individuals undergoing TAVR procedures are often frail and executively compromised due to their cerebrovascular disease. We encourage additional research on the value of digitally-acquired clock drawing within different surgery types. Type of cognitive impairment and the value of digitally-acquired CDT command and copy parameters in other surgeries remain unknown.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Proof of concept: digital clock drawing behaviors prior to transcatheter aortic valve replacement may predict length of hospital stay and cost of care

Wiggins

Dion

Formanski

et al. 2021

Exploration of Medicine

Self Cite

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Gaze data of 4243 participants shows link between leftward and superior attention biases and age

Strauch,

Hoogerbrugge,

Ten Brink

2024

Exp Brain Res

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Healthy individuals typically show more attention to the left than to the right (known as pseudoneglect), and to the upper than to the lower visual field (known as altitudinal pseudoneglect). These biases are thought to reflect asymmetries in neural processes. Attention biases have been used to investigate how these neural asymmetries change with age. However, inconsistent results have been reported regarding the presence and direction of age-related effects on horizontal and vertical attention biases. The observed inconsistencies may be due to insensitive measures and small sample sizes, that usually only feature extreme age groups. We investigated whether spatial attention biases, as indexed by gaze position during free viewing of a single image, are influenced by age. We analysed free-viewing data from 4,243 participants aged 5–65 years and found that attention biases shifted to the right and superior directions with increasing age. These findings are consistent with the idea of developing cerebral asymmetries with age and support the hypothesis of the origin of the leftward bias. Age modulations were found only for the first seven fixations, corresponding to the time window in which an absolute leftward bias in free viewing was previously observed. We interpret this as evidence that the horizontal and vertical attention biases are primarily present when orienting attention to a novel stimulus – and that age modulations of attention orienting are not global modulations of spatial attention. Taken together, our results suggest that attention orienting may be modulated by age and that cortical asymmetries may change with age.

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Heilman

Libon

Sun

et al. 2021

Brain and Cognition

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Age-Related Changes in the Allocation of Vertical Attention

Abstract: Normal upward attentional bias increases with aging, possibly due to an age-related reduction of the dorsal attentional stream that is responsible for the allocation of downward attention. (JINS, 2018, 24, 1121-1124).

Cited by 15 publications

References 14 publications

Proof of concept: digital clock drawing behaviors prior to transcatheter aortic valve replacement may predict length of hospital stay and cost of care

Proof of concept: digital clock drawing behaviors prior to transcatheter aortic valve replacement may predict length of hospital stay and cost of care

Gaze data of 4243 participants shows link between leftward and superior attention biases and age

Right up- left down

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