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Catch the ruler: concurrent validity and test–retest reliability of the ReacStick measures of reaction time and inhibitory executive function in older people

  • Kimberley S. van Schooten
  • Lionne Duran
  • Maike Visschedijk
  • Mirjam Pijnappels
  • Stephen R. Lord
  • James Richardson
  • Kim Delbaere
Original Article
  • 22 Downloads

Abstract

Background

Reduced cognitive function, particularly executive function (EF), is associated with an increased risk of falling in older people. We evaluated the utility of the ReacStick test, a clinical test of reaction time, and inhibitory EF developed, for young athletes, for fall-risk assessment in older people.

Aims

To evaluate the psychometric properties of ReacStick measures of reaction time and executive functioning in healthy community-dwelling older people.

Methods

140 participants (aged 77 ± 5 years) underwent testing. Two test conditions—simple and inhibitory go/no-go—provided measures of reaction time, recognition load (difference in reaction time between conditions), and go/no-go accuracy. Concurrent validity was evaluated against the conventional tests of reaction time and EF (simple hand reaction time, trail-making test, and Stroop colour test). Discriminant ability was determined for fall-risk factors (age, gender, physiological profile assessment, and fall history). Test–retest reliability after 1 week was evaluated in 30 participants.

Results

ReacStick reaction time correlated with tests of reaction time and EF, recognition load correlated with inhibitory EF, and go accuracy correlated with reaction time and inhibitory EF. No-go accuracy was not significantly correlated with any of the reaction time and EF tests. Test–retest reliability was good-to-excellent (ICC > 0.6) for all the outcomes. ReacStick reaction time discriminated between groups based on age, recognition load between genders, and no-go accuracy between retrospective fallers and non-fallers.

Discussion

An unavoidable time pressure may result in complementary information to the traditional measures.

Conclusions

The ReacStick is a reliable test of reaction time and inhibitory EF in older people and could have value for fall-risk assessment.

Keywords

Task switching Cognition Go–no-go Accidental falls Aged 

Notes

Acknowledgements

We like to thank our participants for participating, and research assistants Jessica Chow, Garth McInerney, Ashton May, Lillian Miles, Linda Pickett, Daniel Steffens, and Ashley Woodbury for their help with participant recruitment and assessments.

Funding

This work was supported by the Human Frontier Science Program (HFSP long-term fellowship number LT001080/2017); the Dutch Organisation for Scientific Research (NWO VIDI Grant number 91714344); the Newman Family Foundation; the Australian National Health and Medical Research Council (NHMRC project Grant number 1084739).

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Springer S, Giladi N, Peretz C et al (2006) Dual-tasking effects on gait variability: the role of aging, falls, and executive function. Mov Disord 21:950–957.  https://doi.org/10.1002/mds.20848 CrossRefPubMedGoogle Scholar
  2. 2.
    Yogev-Seligmann G, Hausdorff JM, Giladi N (2008) The role of executive function and attention in gait. Mov Disord 23:329–342.  https://doi.org/10.1002/mds.21720 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lord S, Galna B, Verghese J et al (2013) Independent domains of gait in older adults and associated motor and nonmotor attributes: validation of a factor analysis approach. J Gerontol Ser A Biol Sci Med Sci 68:820–827.  https://doi.org/10.1093/gerona/gls255 CrossRefGoogle Scholar
  4. 4.
    Herman T, Mirelman A, Giladi N et al (2010) Executive control deficits as a prodrome to falls in healthy older adults: a prospective study linking thinking, walking, and falling. J Gerontol Ser A Biol Sci Med Sci 65:1086–1092.  https://doi.org/10.1093/gerona/glq077 CrossRefGoogle Scholar
  5. 5.
    Mirelman A, Herman T, Brozgol M et al (2012) Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition. PLoS One 7:e40297.  https://doi.org/10.1371/journal.pone.0040297 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Delbaere K, Kochan NA, Close JC et al (2012) Mild cognitive impairment as a predictor of falls in community-dwelling older people. Am J Geriatr Psychiatry 20:845–853.  https://doi.org/10.1097/JGP.0b013e31824afbc4 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hsu CL, Nagamatsu LS, Davis JC et al (2012) Examining the relationship between specific cognitive processes and falls risk in older adults: a systematic review. Osteoporos Int 23:2409–2424.  https://doi.org/10.1007/s00198-012-1992-z CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Montero-Odasso M, Verghese J, Beauchet O et al (2012) Gait and cognition: a complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc 60:2127–2136.  https://doi.org/10.1111/j.1532-5415.2012.04209.x CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Verbruggen F, Logan GD (2009) Models of response inhibition in the stop-signal and stop-change paradigms. Neurosci Biobehav Rev 33:647–661.  https://doi.org/10.1016/j.neubiorev.2008.08.014 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Wecker NS, Kramer JH, Wisniewski A et al (2000) Age effects on executive ability. Neuropsychology 14:409–414CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Diamond A (2013) Executive functions. Annu rev Psychol 64:135–168CrossRefPubMedCentralGoogle Scholar
  12. 12.
    Miyake A, Friedman NP, Emerson MJ et al (2000) The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: a latent variable analysis. Cogn Psychol 41:49–100.  https://doi.org/10.1006/cogp.1999.0734 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Collins A, Koechlin E (2012) Reasoning, learning, and creativity: frontal lobe function and human decision-making. PLoS Biol 10:e1001293.  https://doi.org/10.1371/journal.pbio.1001293 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Lunt L, Bramham J, Morris RG et al (2012) Prefrontal cortex dysfunction and ‘Jumping to Conclusions’: bias or deficit? J Neuropsychol 6:65–78.  https://doi.org/10.1111/j.1748-6653.2011.02005.x CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Whiteside DM, Kealey T, Semla M et al (2016) Verbal fluency: language or executive function measure? Appl Neuropsychol Adult 23:29–34.  https://doi.org/10.1080/23279095.2015.1004574 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Anstey KJ, Wood J, Kerr G et al (2009) Different cognitive profiles for single compared with recurrent fallers without dementia. Neuropsychology 23:500CrossRefGoogle Scholar
  17. 17.
    Schoene D, Delbaere K, Lord SR (2017) Impaired response selection during stepping predicts falls in older people—a cohort study. J Am Med Dir Assoc 18:719–725CrossRefGoogle Scholar
  18. 18.
    Eckner JT, Richardson JK, Kim H et al (2012) A novel clinical test of recognition reaction time in healthy adults. Psychol Assess 24:249–254.  https://doi.org/10.1037/a0025042 CrossRefPubMedGoogle Scholar
  19. 19.
    Eckner JT, Chandran S, Richardson JK (2011) Investigating the role of feedback and motivation in clinical reaction time assessment. PM R J Injury Funct Rehabil 3:1092–1097.  https://doi.org/10.1016/j.pmrj.2011.04.022 CrossRefGoogle Scholar
  20. 20.
    Eckner JT, Kutcher JS, Broglio SP et al (2014) Effect of sport-related concussion on clinically measured simple reaction time. Br J Sports Med 48:112–118.  https://doi.org/10.1136/bjsports-2012-091579 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Eckner JT, Lipps DB, Kim H et al (2011) Can a clinical test of reaction time predict a functional head-protective response? Med Sci Sports Exerc 43:382–387.  https://doi.org/10.1249/MSS.0b013e3181f1cc51 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Delbaere K, Valenzuela T, Woodbury A et al (2015) Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial. BMJ Open 5:e009173.  https://doi.org/10.1136/bmjopen-2015-009173 CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Lord SR, Menz HB, Tiedemann A (2003) A physiological profile approach to falls risk assessment and prevention. Phys Ther 83:237–252PubMedPubMedCentralGoogle Scholar
  24. 24.
    Lezak MD, Howieson DB, Loring DW et al (2004) Neuropsychological assessment. Oxford University Press, USAGoogle Scholar
  25. 25.
    Sanchez-Cubillo I, Perianez JA, Adrover-Roig D et al (2009) Construct validity of the Trail Making Test: role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. J Int Neuropsychol Soc 15:438–450.  https://doi.org/10.1017/S1355617709090626 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd. Erlbaum, HillsdaleGoogle Scholar
  27. 27.
    Cicchetti D (1994) Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instrument in psychology. Psychol Assess 6:284–290CrossRefGoogle Scholar
  28. 28.
    Eckner JT, Whitacre RD, Kirsch NL et al (2009) Evaluating a clinical measure of reaction time: an observational study. Percept Motor Skills 108:717–720CrossRefPubMedCentralGoogle Scholar
  29. 29.
    Montare A (2010) The simplest chronoscope II: reaction time measured by meterstick versus machine. Percept Mot Skills 111:819–828CrossRefPubMedCentralGoogle Scholar
  30. 30.
    Goodale MA, Milner AD (1992) Separate visual pathways for perception and action. Trends Neurosci 15:20–25CrossRefPubMedCentralGoogle Scholar
  31. 31.
    Bari A, Robbins TW (2013) Inhibition and impulsivity: behavioral and neural basis of response control. Progress Neurobiol 108:44–79CrossRefGoogle Scholar
  32. 32.
    Salthouse TA (1996) The processing-speed theory of adult age differences in cognition. Psychol Rev 103:403CrossRefPubMedCentralGoogle Scholar
  33. 33.
    Der G, Deary IJ (2006) Age and sex differences in reaction time in adulthood: results from the United Kingdom Health and Lifestyle Survey. Psychol Aging 21:62CrossRefPubMedCentralGoogle Scholar
  34. 34.
    Richardson JK, Eckner JT, Allet L et al (2017) Complex and simple clinical reaction times are associated with gait, balance, and major fall injury in older subjects with diabetic peripheral neuropathy. Am J Phys Med Rehabil 96:8CrossRefPubMedCentralGoogle Scholar
  35. 35.
    Verghese J, Wang C, Ayers E et al (2017) Brain activation in high-functioning older adults and falls: Prospective cohort study. Neurology 88:191–197.  https://doi.org/10.1212/WNL.0000000000003421 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Neuroscience Research AustraliaUniversity of New South WalesSydneyAustralia
  2. 2.Department of Human Movement Sciences, Faculty of Behavioural and Movement SciencesVrije Universiteit, Amsterdam Movement SciencesAmsterdamThe Netherlands
  3. 3.Department of Physical Medicine and RehabilitationUniversity of MichiganAnn ArborUSA

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