Bingo! Externally supported performance intervention for deficient visual search in normal aging, Parkinson's disease, and Alzheimer's disease

Abstract

External support may improve task performance regardless of an individual’s ability to compensate for cognitive deficits through internally-generated mechanisms. We investigated if performance of a complex, familiar visual search task (the game of bingo) could be enhanced in groups with suboptimal vision by providing external support through manipulation of task stimuli. Participants were 19 younger adults, 14 individuals with probable Alzheimer’s disease (AD), 13 AD-matched healthy adults, 17 non-demented individuals with Parkinson’s disease (PD), and 20 PD-matched healthy adults. We varied stimulus contrast, size, and visual complexity during game play. The externally-supported performance interventions of increased stimulus size and decreased complexity resulted in improvements in performance by all groups. Performance improvement through increased stimulus size and decreased complexity was demonstrated by all groups. AD also obtained benefit from increasing contrast, presumably by compensating for their contrast sensitivity deficit. The general finding of improved performance across healthy and afflicted groups suggests the value of visual support as an easy-to-apply intervention to enhance cognitive performance.

Linking cognitive and visual perceptual decline in healthy aging: The information degradation hypothesis

“…Neither the younger nor older adults were affected by the contrast manipulation, which differs from Toner et al (2012) who found an effect of contrast. This difference between studies may be due to Laudate et al (2012) using a higher baseline visual contrast (62% Michelson contrast) than Toner et al (22% Michelson contrast). However, overall Laudate et al supports the information degradation hypothesis, in which a manipulation of visual acuity affected both older and younger adults’ task performance.…”

“…In another study testing the information degradation hypothesis in visual search (Laudate et al, 2012), older and younger adults played bingo on a touch-screen computer presented under several visual conditions (This study also reported results for Alzheimer’s and Parkinson’s disease patients, not discussed here.). In order to ensure that the results were not due to age-differences in motor speed, the authors controlled for Purdue Pegboard (Lafayette Instrument, Lafayette, IL, United States) performance when appropriate.…”

“…In summary, Toner et al (2012) and Laudate et al (2012) provide some support for the information degradation hypothesis, because simple visual manipulations affected task performance for both younger and older adults, and older adults’ performance could be raised to the level of the younger adults by equating the proximal signal strength of the two age groups (Toner et al, 2012). However, inconsistent with this hypothesis, both studies found that both the younger and older adults were equally affected by the contrast manipulations.…”

At the interface of sensory and motor dysfunctions and Alzheimer's disease

“…Recent work by Cronin-Golomb, Gilmore and their colleagues has provided some evidence that the performance of AD patients in tasks such as letter identification, word reading, picture naming, face discrimination, and digit cancellation (133) can be improved, sometimes to normal levels, simply by increasing the contrast of stimuli to compensate for their contrast sensitivity deficit (134–136). In addition, enhancing the contrast or strength of visual stimuli may improve advanced AD patients’ activities of daily living, such as pill finding (137), playing Bingo (138), and eating (139). The positive impact of stimulus enhancement has been shown in patients who had been screened for visual acuity and major age-related vision problems, such as cataracts, glaucoma, and macular degeneration (133–138).…”

“…In addition, enhancing the contrast or strength of visual stimuli may improve advanced AD patients’ activities of daily living, such as pill finding (137), playing Bingo (138), and eating (139). The positive impact of stimulus enhancement has been shown in patients who had been screened for visual acuity and major age-related vision problems, such as cataracts, glaucoma, and macular degeneration (133–138). It is likely that the stimulus enhancement would not help patients with severe vision pathology.…”