This study examines two independent aspects of cognition, deductive and probabilistic reasoning to differentiate between their relationship to physical fitness in older adults. This study measured the deductive and probabilistic reasoning abilities of 65 community dwelling older adults ranging in age from 55 to 92 (M = 74.88, SD = 6.70). A series of three-line syllogisms was used to measure both probabilistic and deductive reasoning while physical testing was carried out using the Senior Fitness Test (SFT). Results showed deductive reasoning to be positively correlated with the SFT, particularly lower body strength (chair stands; r = .40), aerobic fitness (2-minute step test; r = .37), and agility/dynamic balance (8-foot up-and-go [smaller score is better]; r = -.29). However, no relationship was found between physical fitness and probabilistic reasoning.

The Department ChairVolume 31, Issue 1 p. 1-3 Articles Values-Based Leadership: Culture versus Strategy Kimberly Miloch, Kimberly MilochSearch for more papers by this authorChristopher T. Ray, Christopher T. RaySearch for more papers by this authorAbigail Tilton, Abigail TiltonSearch for more papers by this author Kimberly Miloch, Kimberly MilochSearch for more papers by this authorChristopher T. Ray, Christopher T. RaySearch for more papers by this authorAbigail Tilton, Abigail TiltonSearch for more papers by this author First published: 30 June 2020 https://doi.org/10.1002/dch.30324Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume31, Issue1Summer 2020Pages 1-3 RelatedInformation

At the outset, it should be noted that the term biopsychosocial model was originally introduced by George Engel, G. L. (1977. The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136; Engel, G. L. (1980). The clinical application of the biopsychosocial model. The American Journal of Psychiatry, 137(5), 535–544) because he felt that the traditionally embraced biomedical reductionist model in medicine was outdated in light of the newer advances in medicine. He emphasized that modern medicine needed to encompass a more dynamic system approach, which included different levels of organization that included not only factors related to the patient and physician but also other important sociocultural and lifestyle variables in a “systems theory” manner initially introduced in biology by scientists such as Weiss, P. (1969. The living system: Terminism stratified. In J. Smythies & A. Koestler (Ed.), Beyond reductionism. New York, NY: Macmillan Publishing Co; Weiss, P. (1977). The system of nature and the nature of systems: empirical holism and practical reductionism harmonized. In K. E. Schaefer, H. Hensel, & R. Brody (Eds.), Toward a man-centered medical science. Mt. Kisco, NY: Futura Publishing Co) and von Bertalanffy, L. V. (1968. General systems theories: Foundations, development and applications. New York, NY: G. Braziller; von Bertalanffy, L. (1969). Chance or law. In J. Smythies & A. Koestler (Eds.), Beyond reductionism. New York, NY: Macmillan Publishing Co).

In this article we offer a two-part commentary on Bolton and Gillett’s reconceptualization of Engel’s biopsychosocial model. In the first section we present a conceptual and historical assessment of the biopsychosocial model that differs from the analysis by Bolton and Gillett. Specifically, we point out that Engel in his vision of the biopsychosocial model was less concerned with the ontological possibility and nature of psychosocial causes, and more concerned with psychosocial influences in the form of illness interpretation and presentation, sick role, seeking or rejection of care, the doctor-patient therapeutic relationship, and role of personality factors and family relationships in recovery from illness, etc. On the basis of this assessment, we then question Bolton and Gillett’s restricted focus on accounting for biopsychosocial causal interactions. The second section compares Bolton and Gillett’s account with a recent enactivist account of mental disorder that tackles similar conceptual problems of causal interactions. Bolton and Gillett’s utilize elements of the 4E cognition, but they combine these proto-ideas with an information-processing paradigm. Given their explicit endorsement of 4E approaches to mind and cognition, we illustrate some key ways in which a more fleshed out enactive account, particularly one that doesn’t rely on notions of information-processing, differs from the account proposed by Bolton and Gillett.

Proper gait and postural stability are important factors for maintaining quality of life and performing activities of daily living with ease in older adults. Dysfunction with these motor abilities may increase the risk of falls and lead to more frequent hospitalizations. To assess gait and posture in the aging population, the appropriate variables need to be identified first. The tools and equipment to measure these variables can then be determined. For example, spatiotemporal parameters can be used to characterize gait. To quantify these parameters, timing mats, wearable inertial sensors, motion capture, force plates, and optical sensors may be used. Motion capture and force plates can also be used to measure the kinematics and kinetics of gait. To assess posture, body-worn sensors, force plates, and other specialized equipment can be used to determine acceleration patterns of the torso, center-of-pressure kinematics, or a combination of the two, respectively. Validated clinical assessments, including questionnaires and ordinal scales, can be used to further characterize gait, posture, and balance in older adults. Finally, data analysis strategies, often combined with validated tools and equipment, can be implemented in an attempt to further describe the underlying mechanisms of gait and postural control. These strategies include power spectral analysis, principal component analysis, gait variability, stabilogram-diffusion analysis, and the pinned-polymer model and fluctuation-dissipation theorem applied to postural control. With this information, the healthcare practitioner may be more aware of the measurement tools and strategies to monitor changes in gait and posture in the aging population.

Falls are common and costly in older adults. Risk factors include deficits in gait and postural control, both of which are linked to cognitive impairments. These cognitive impairments may be attributed to a genetic predisposition. A previous study found that a genetic risk factor related to Alzheimer's disease (the ApoE‐ε4 genetic variant) is also related to gait speed decline in older adults. No research has attempted to assess the impact of this variant on postural control in older adults. The purpose of this pilot study was to replicate the gait findings and extend these to measures of balance in older adults. Forty‐six older adults, without a history of neurological disorder, were genotyped and had their gait and postural control assessed. Surprisingly, analyses showed lowered double‐stance time for carriers than noncarriers of the ε4 isoform. However, no significant differences were observed between carriers and noncarriers for any other comparisons, including postural control scores. Results suggest that the ε4 isoform may affect gait, but not postural control.

This present study investigated whether older adults' ability to accurately discriminate between deductive and probabilistic reasoning tasks declines with age, and whether this ability correlates with cognitive ability as measured by the Montreal Cognitive Assessment (MoCA) test. Seventy‐eight adults (65–92 years) were tested for their abilities to carry out deductive and probabilistic reasoning. Pearson correlations were conducted to determine the relationships among age, MoCA, deductive reasoning, probabilistic reasoning, and overall discrimination ability. Separate single‐factor analyses of variance were used to determine differences across age groups (65–74, 75–84, 85–94) on the MoCA, deductive and probabilistic reasoning, and overall discrimination ability. Ability to discriminate between the two tasks did not decline with age, nor did they correlate with scores of cognitive ability as measured by the MoCA. Furthermore, those with MoCA scores showing mild cognitive impairment appeared to retain all of these abilities. This leads to the conclusion that reasoning abilities may be retained while general cognitive skills decline. This in turn supports the notion that reasoning, both deductive and probabilistic, may be more domain specific than they are often considered to be.

Age-related declines in postural control and physical fitness are strong risk factors for falls in older adults. Balance efficacy has been utilized to identify poor postural control, reduced physical function, and fall risk. However, it is not clear as to whether balance efficacy is truly a better predictor of functional fitness outcomes or postural control. Distinguishing these associations is an important step in the future derivation of physiotherapeutic programming to remediate acute and chronic decline. Therefore, the purpose of this cross-sectional study was to partition which measures are more associated with balance efficacy, fitness, or postural control. One hundred eleven community-dwelling older adults participated and were asked to complete the Balance Efficacy Scale (BES), a functional fitness measure (the Senior Fitness Test [SFT]), and a measure of postural control (the Sensory Organization Test [SOT]).We found that the SFT was more significantly associated with balance efficacy ( R 2 = .37) than the SOT ( R 2 = .08) in older adults. Overall, aerobic endurance, functional mobility in the SFT, and the vestibular score on the SOT were significantly associated with balance efficacy. We concluded that clinicians utilizing the BES as a preliminary screen should recommend physiotherapy follow-up activities that build endurance (walking), lower extremity functional mobility (sit-to-stand), and vestibular function (head movement while walking). Understanding the links between a preliminary screening tool and the physiological needs of the patient will allow for targeted activities to be prescribed.

Fear-avoidance (FA) beliefs are significantly associated with the experience of pain, especially when the pain becomes chronic in nature. The anticipated threat of intense pain will often result in the constant vigilance and monitoring of pain sensations, which, in turn, can cause even low-intensity sensations of pain to become unbearable for the person. Just the anticipation of increased pain or reinjury can further stimulate avoidance behaviors. A vicious cycle may develop, in which fears of increased pain or reinjury contribute to the avoidance of many activities, leading to inactivity and, ultimately, to greater disability. Anyone who assesses and treats pain-related disability should also be prepared to assess and treat pain-related FA.

This study examined the biopsychosocial characteristics of chronic low back pain (CLBP) in an understudied but increasingly larger part of the population: the elderly (i.e., 65 years and older). A new innovative physical functioning measure (postural control, which is a proxy for the common problem of slips and falls in the elderly) was part of this biopsychosocial evaluation. Also, the National Institutes of Health (NIH)-developed Patient-Reported Outcome Measurement Information System (PROMIS) was also part of this comprehensive evaluation. Two demographically-matched groups of elderly participants were evaluated: one with CLBP (n = 24); and the other without (NCLBP, n = 24). Results revealed significant differences in most of these measures between the two groups, further confirming the importance of using a biopsychosocial approach for future studies of pain and postural control in the elderly.

Falls are the most-common causes of unintentional injury and death in older adults. Many clinics, hospitals, and health-care providers are urgently seeking accurate, low-cost, and easy-to-use technology to predict falls before they happen, e.g., by monitoring the human walking pattern (or "gait"). Despite the wide popularity of Microsoft's Kinect and the plethora of solutions for gait monitoring, no strategy has been proposed to date to allow non-expert users to calibrate the cameras, which is essential to accurately fuse the body motion observed by each camera in a single frame of reference. In this paper, we present a novel multi-Kinect calibration algorithm that has advanced features when compared to existing methods: 1) is easy to use, 2) it can be used in any generic Kinect arrangement, and 3) it provides accurate calibration. Extensive real-world experiments have been conducted to validate our algorithm and to compare its performance against other multi-Kinect calibration approaches, especially to show the improved estimate of gait parameters. Finally, a MATLAB Toolbox has been made publicly available for the entire research community.

Gait characteristics serve as indicators of fall risk. Exercise interventions have been shown to improve gait. However, the use of interactive video games with biofeedback to reduce fall risk has not been well explored. Eighty-two older adults were randomly assigned to either a traditional fitness or Wii group. Both 10-week interventions involved 45-minute exercise sessions (3 days per week). Pre- and post-testing gait measurements were taken. Both groups significantly improved velocity, stride length, cadence, swing time, and decreased double support time (p < .05). Interactive video games offer a promising alternative to traditional group exercise for older adults.

The understanding of prefrail and nonfrail older adults' postural control with and without increased environmental and cognitive stress is imperative to the development of targeted interventions to decrease fall risk within these populations. Thirty-eight individuals participated in this study. Postural control testing included the Sensory Organization Test (SOT) on a NeuroCom EquiTest. Cognitive and environmental load testing was performed during Condition 6 of the SOT. Though there were no group differences on composite equilibrium score (p = .06), the cognitive task (Stroop task) impaired equilibrium scores more than the auditory or visual distracter tasks (p < .05 and p < .01) for both groups. These results suggest that both prefrail and nonfrail older adults' postural control is reduced in demanding environments. Given these findings, the need for multimodal exercise interventions to target both physical and cognitive factors is apparent.

Injuries sustained from falls in elderly can lead to injury, sustained hospital stays, and is one of the leading causes of death in the elderly. An individual’s postural stability has been shown to be a reliable predictor of fall risk. However, postural control in previous research has typically been determined under static balance conditions. Despite this, clinical observations indicate that falls in elderly individuals are more likely to occur under low-light conditions during movement. The purpose of this study was to determine anterior/posterior dynamic stability in young and elderly subjects while walking with eyes open and eyes closed. An inverted pendulum model derived from a 14 segment full-body kinematic (120 Hz) and kinetic (1080 Hz) data set was used to determine dynamic stability against backward loss of balance. Five young subjects (age 24.8 ± 4.2 years, height 177.8 ± 9.7, mass 74.0 ± 14.2 kg) and seven elderly subjects (age 74.7 ± 7.7, height 174.2 ± 6.7, mass 82.3 ± 15.5 kg) were recruited. All procedures were approved by the IRB and subjects gave informed consent. Data were collected in the Biomechanics Laboratory at the University of Texas at Arlington using two AMTI force plates (1080 Hz) and a Vicon Motion Capture System (120 Hz). Each subject was allowed multiple practice trials to ensure contact with both force plates was made. Each subject completed five walking trials with eyes open and five with eyes closed. Dynamic stability was determined by computing the momentum of the extrapolated center of mass (Hof, 2005). A 2 x 2 repeated measures ANOVA was used to determine the effect of vision (eyes open, eyes closed) and age (young, elderly) on dynamic stability. There were no significant differences in dynamic stability for the young subjects for eyes open (330.2 ± 19.8 kg·mm/s) and eyes closed (323.8 ± 31.9 kg·mm/s), p < 0.05. There were no significant differences in dynamic stability for the elderly subjects for eyes open (304.5 ± 28.2 kg·mm/s) and eyes closed (288.2 ± 40.8 kg·mm/s), p < 0.05. Finally, the interaction between vision and age group was not significant, p < 0.05. A larger subject number could potentially yield significant differences for both betweenand within-subjects factors. While not statistically significant the inverted pendulum model did illustrate that elderly subjects had lower dynamic stability. In addition dynamic stability was lower for both groups when walking with eyes closed.

Gait and postural control are important aspects of human movement and balance. Normal movement control in human is subject to change with aging. With aging, the nervous system comprising, somatosensory, visual senses, spatial orientation senses, and neuromuscular control degrade. As a result, the body movement control such as the lateral sway while walking is affected which has been shown to be a significant cause of falling among the elderly. Biofeedback has been investigated to assist elderly improve their body movement and postural ability, by supplementing the feedback to the nervous system. In this paper, we propose a wearable low-power sensor system capable of characterizing lateral sway and gait parameters. Then, it can provide corrective feedback to reduce excessive sway in real-time via vibratory feedback modules. Real-time and low-power characteristics along with wearability of our proposed system allow long-term continuous subjects' sway monitoring while giving direct feedback to enhance walking sway and prevent falling. It can also be used in the clinics as a tool for evaluating the risks of falls, and training users to better maintain their balance. The effectiveness of the biofeedback system was evaluated on 12 older adults as they performed gait and stance tasks with and without biofeedback. Significant improvement (p-value < 0.1) in sway angle in variance of the sway angle, variance of gait phases, and in postural control while on perturbed surface was detected when the proposed Sway Error Feedback System was used.