Contextual Processing and the Impacts of Aging and Neurodegeneration: A Scoping Review

Figures & data

Figure 1 The literature search and article selection process.

Table 1 Summary of Publications Reviewed in This Study

First Author	Year of Publication	Subject [Mean Age (sd or Range)]	Study Method	Task(s) Involved	Main Findings
(A) Normal Aging
Braver^Citation81	2001	YA [24.6 (5.5)]; n = 175 OA [72.0 (5.1)]; n = 81	Behavioural	AX-CPT	OA performed poorly on the BX and AX trials of the AX-CPT; they had impaired proactive control and were unable to use the cue as efficiently as the YA group to anticipate the upcoming target. However, OA performed faster on AY trials, suggesting preserved reactive control.
Rush^Citation79	2006	YA [19.8 (1.9)]; n = 51 OA [74.8 (4.3)]; n = 56	Behavioural	AX-CPT, Stroop, garden path sentences, go no-go, and stop-signal task	Compared to YA, OA made fewer errors on AY trials, indicating intact reactive control in responding to novel stimuli. OA also had a longer reaction time relative to YA on BX trials, which required proactive control. OA also had trouble inhibiting inappropriate responses for stop-signal and Stroop task. YA and OA performed similarly on the garden path and go no-go tasks.
West^Citation71	2006	YA [20.50 (0.61)]; n = 20 OA [71.75 (7.79)]; n = 20	Behavioural and EEG	Counting task	OA responded more slowly when they attempted to maintain contextual information over a longer period of time (5000 ms vs 2000 ms), showing a decrease in contingent negative variation amplitude. OA also needed additional cognitive loads for tasks that were relatively easy for YA.
Paxton^Citation77	2008	Experiment 1: YA [22.8 (3.7)]; n = 21 OA [73 (5.7)]; n = 20 Experiment 2: YA [21.56 (3.14)]; n =16 OA [72.38 (6.51)]; n = 16	Event-related fMRI	AX-CPT	Experiment 1: OA had increased errors and reaction times on BX trials, but less errors and faster reaction times on AY trials than YA. OA had greater activity in their lateral PFC when performing this task, compared to YA. Experiment 2: OA displayed sustained activity in the anterior and posterior brain regions whereas YA only showed transient activity in these regions. During cue-related activity, OA exhibited reduced activity in the right dorsolateral PFC, suggesting impaired ability to encode/maintain information.
De Sanctis^Citation96	2009	YA [24.1 (20–35)]; n = 15 HP OA [70 (66–82)]; n = 10 LP OA [69.7 (66–82)]; n = 9	EEG	Letter and number categorization task	LP OA showed a reduced P3 activity over the centro-parietal regions whereas the HP OA showed a robust P3, with the latter group exhibiting more robust activity in their PFC. This suggests a correlation of maintaining high levels of executive function and PFC activity in OA.
Fogelson^Citation65	2010	YA [24]*; n = 12 OA [65]*; n = 11	EEG	Predictive Sequence Visual Task	OA exhibited a greater P3b latency in contrast to YA. OA also exhibited a late sustained positivity after the detection of predicted and random targets, indicating their uncertainties in making decisions.
Hämmerer^Citation70	2010	C [10.15 (0.59)]; n = 42 A [14.42 (0.55)]; n = 44 YA [24.27 (2.07)]; n = 46 OA [71.24 (2.91)]; n = 47	EEG	AX-CPT	C, A and YA participants paid more attention to the Cue stimulus in contrast to the Non-Cue stimulus as shown by the increased P3 amplitude for the former. OA on the other hand were the only ones that exhibited a spike in their P3a amplitude for the Non-cue stimulus, suggesting increased attentional distractibility.
Trewartha^Citation95	2013	YA [22.4 (2.8)]; n = 17 OA [72.3 (5.0)]; n = 15	EEG	Multi-finger sequencing task	OA’s P3b amplitude was reduced and its onset was delayed compared to YA when presented with conflicting stimuli, indicating reduced ability to differentiate task-relevant from distractor items. YA had larger P3b amplitudes in trials where they responded faster, suggesting better context updating in correlation with faster task execution.
Bugg^Citation78	2014	Experiment 1: YA [19.20 (1.04)]; n = 16 OA [74.68 (6.32)]; n = 25 Experiment 2: YA [19.20 (1.04)]; n = 25 OA [70.00 (5.93)]; n = 17	Behavioural	Stroop task and flanker interference	Experiment 1: OA performed similarly to YA in trials where there was a high level of interference. However, in trials with low interference, OA performed much worse than YA. This suggests that when faced continuously with conflicting information, OA are able to use their reactive control to select the appropriate response and that their reactive control is relatively similar to YA. Experiment 2: both YA and OA demonstrated less flanker interference when stimuli were presented in trials with high levels of interference in contrast with trials with low levels of interference.
Schmitt^Citation10	2014	YA [22.4 (2.4)]; n =18 OA [75.1 (3.8)]; n =18	Behavioural and EEG	AX-CPT	In YA, P3b amplitude increased from frontal to parietal electrodes mainly on the context-dependent trials. OA, instead, exhibited comparable P3b amplitudes on context-dependent and context-independent trials, suggesting that OA were more easily distracted by irrelevant stimuli in contrast to YA.
Manard^Citation74	2017	YA [23.5 (3.22)]; n = 20 OA [65.1 (3.8)]; n = 20	Event-related fMRI	Stroop task	OA exhibited increased activity in the left inferior frontal areas and the anterior striatum when engaged in conflict resolution and suppressing of irrelevant information. When engaged in proactive control, OA exhibited increased activity in the middle frontal gyrus. OA also recruited the left inferior frontal operculum more than YA for reactive control.
(B) Mild Cognitive Impairment (MCI)
Cespón^Citation85	2013	mdaMCI [71.0 (9.2)]; n = 13 sdaMCI [67.0 (9.1)]; n = 17 Control [65.0 (8.1)]; n = 25	Behavioural and EEG	Simon task	mdaMCI patients exhibited more errors in the Simon task compared to the other two groups. In addition, the N2pc amplitude (ERP marker associated with visuospatial processes) was smaller in the mdaMCI group compared to controls. Lastly, both mdaMCI and sdaMCI patients had a lower LRP amplitude (an ERP marker for motor processes) than control groups.
Cid-Fernández^Citation82	2014	aMCI [69.5 (8.2)]; n = 30 Control [65.9 (8.0)]; n = 63	Behavioural and EEG	Go no-go task	aMCI patients had longer reaction times and less accuracy in the Go no-go task in contrast to the control group. aMCI patients also had lower N2 amplitudes for the Go no-go task compared to controls, which indicated that they were less skilled at detecting task-relevant stimulus and inhibiting inappropriate responses.
Cespón^Citation86	2015	mdaMCI [71.2 (2.06)]; n = 12 sdaMCI [69.1 (1.98)]; n = 13 Control [68.3 (1.68)]; n = 18	Behavioural and EEG	Simon task	The mdaMCI patients made more errors on the Simon task than the sdaMCI patients and the controls. This was supported by the EEG data, showing that the mdaMCI group had longer N2cc latencies, ie, ERP markers for selective attention in tactile processes.
Ramos-Goicoa^Citation83	2016	aMCI [70.7 (9.1)]; n =39 Control [65.4 (9.2)]; n =45	Behavioural and EEG	Stroop task	aMCI patients struggled with selecting and preparing for a motor response (lower LRP amplitudes relative to control group). aMCI patients also evaluated and classified congruent and incongruent stimuli more slowly than controls, as shown by the longer P3b latencies.
Cid-Fernández^Citation84	2017	mdaMCI [72.1 (6.9)]; n =12 sdaMCI [68.7 (10.1)]; n = 22 Control [67.0 (9.8)]; n =20	Behavioural and EEG	Auditory-visual distraction-attention task	mdaMCI group performed the worst out of all the 3 groups, with longer reaction times and more incorrect responses. sdaMCI group performed at an intermediate level relative to control and mdaMCI.
Cid-Fernández^Citation87	2017	mdaMCI [72.3 (7.3)]; n =12 sdaMCI [68.3 (10.1)]; n =21 Control [66.2 (9.2)]; n =19	Behavioural and EEG	Auditory-visual distraction-attention task	mdaMCI group had longer reaction times and fewer correct responses than control and sdaMCI groups. mdaMCI group had lower sLRP amplitudes in contrast to control participants whereas sdaMCI had longer sLRP peak latencies (ERP marker for motor processes).
(C) Alzheimer’s Disease
Braver^Citation88	2005	YA [19.8 (1.9)]; n = 51 YO [71.7 (2.3)]; n = 46 OO [81.0 (4.7)]; n = 43 AD [80.1 (7.1)]; n = 26	Behavioural	AX-CPT	Compared with YA, YO experienced issues related to context activation/updating but no additional impairment in context maintenance. Individuals between the ages of 66–75 appeared to be more vulnerable to context activation/updating deficits. In contrast, OO performed worse in the long-delay condition (5000ms) in contrast to the YO, suggesting increased deficits in context maintenance at advanced ages. Additionally, individuals with very mild AD demonstrated even greater level of context maintenance deficits, compared to age-matched OO.
(D) Parkinson’s Disease (on Non-Demented Older Patients)
Wylie^Citation91	2010	OAP [65.9 (8.2)]; n = 52 OA [63.3 (7.9)]; n = 30	Behavioural	Simon task	OAP and OA controls performed similarly on tasks requiring on-line control (ie suppressing incorrect responses within one trial/at a given moment in time). OAP performed as well as OA on tasks requiring proactive control (adjusting control mechanisms to better adapt to future response conflict). On-line cognitive control was more affected as mobility-related impairments increased amongst OAP patients, whereas proactive control remained unaffected.
Fogelson^Citation89	2011	OAP [61.6 (5.6)]; n = 8 OA [63.4 (6.2)]; n = 8	Behavioural and EEG	Predictive sequence visual task	OA processed random and predicted targets differently whereas OAP showed no difference in performance, as shown by the lack of P3b latency shift between the two trials for OAP patients. OA also processed predicted targets faster than random targets but this was not observed in OAP. OAP patients were able to detect targets but experienced difficulties with differentiating task-relevant vs task-irrelevant information.
Fogelson^Citation25	2013	OAP [58.8 (2.3)]; n = 15 OA [58.3 (2.8)]; n =15	EEG	Predictive sequence visual task	OAP patients had higher cluster coefficients and longer path lengths, demonstrating weaker frontal-parietal connections when performing target detection tasks. This was because high cluster coefficients and long path lengths are correlated with increased functional connections within the frontal loops, indicating less neurons/networks to support communications between the frontal and other cortical regions.
Li^Citation90	2018	OAP [58.1 (2.5)]; n = 17 OA [57 (2.6)]; n = 15	EEG	Predictive sequence visual task	OAP patients showed similar P3b amplitude across the implicit and explicit trials (when they were made aware of the predictive sequence and the subsequent target), whereas OA had higher P3b amplitudes for the explicit condition. OAP also exhibited longer P3b latencies for predicted targets compared to random targets in both the implicit and explicit sessions, indicating slower processing speed of predicted targets. OAP also had high degree of connectivity between neural networks (the gamma measurements) when processing contextual information, indicating functional connectivity abnormalities within their top-down frontal networks.
Di Caprio^Citation92	2020	RPD [57.6 (6.8)]; n = 17 LPD [61.6 (5.6)]; n = 17 Controls [58.8 (6.9)]; n = 24	Behavioural	Reaching stop-signal task	Reactive inhibition (ability to immediately stop a behaviour) was reduced in early-stage PD patients (Hoehn and Yahr stage 1) whereas proactive inhibition (ability to shape response strategies according to the context) remained unaffected.

Notes: *No age range or standard deviations were provided. “n” indicates the sample size.

Abbreviations: A, adolescents; AD, Alzheimer’s disease; aMCI, amnestic mild cognitive impairment; AX-CPT, AX continuous performance test; AY, a variation of the AX-CPT; BX, a variation of the AX-CPT; C, children; EEG, electroencephalography; fMRI, functional magnetic resonance imaging; HP, high-performing; LP, low-performing; LPD, left-dominant Parkinson’s disease patients; LRP, lateralized readiness potential; mdaMCI, multiple domain amnestic mild cognitive impairment; N2, an event-related potential associated with detecting mismatched information; N2cc; an event-related potential associated with selective attention in tactile processes; N2pc, an event-related potential associated with selective attention in visuospatial processes; OA, older adults; OAP, older adults with Parkinson’s Disease; OO, old-old adults; P3, an event-related potential associated with decision making; P3a, a component of the P3 that is associated with processing unexpected novel stimuli; P3b, a component of the P3 that is associated with information processing; RPD, right-dominant Parkinson’s disease patients; sd, standard deviation; sdaMCI, single domain amnestic mild cognitive impairment; sLRP, stimulus-locked lateralized readiness potential; YA, young adult; YO, young-old adults.

Figure 2 Summary of current status of contextual processing research in relation to normal and accelerated aging. *It remains to be determined the other effects that normal aging could have on context processing. **It remains to be determined the other effects that MCI could have on context processing. ***mdaMCI patients perform worse than sdaMCI patients. † Unknown effects.

Abbreviations: ACC, anterior cingulate cortex; AD, Alzheimer’s Disease; aMCI, amnestic mild cognitive impairment; CP, context processing; mdaMCI, multiple domain amnestic mild cognitive impairment; PD, Parkinson’s Disease; PFC, prefrontal cortex; sdaMCI, single domain amnestic mild cognitive impairment.

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