These separate subsystems work in concert with the central executive coordinating system. Baddeley and Hitch (1974) postulate that verbal and auditory information are processed by a compartment referred to as the phonological loop (e.g., an inner voice) and that visual information is processed by the visuospatial scratchpad (e.g., contributing to body image). This enables future goals to be achieved despite challenge from distractions. WM is a crucial executive function responsible for holding and manipulating verbal, auditory and visuospatial information after it is no longer present as a cue. A milder degree of restraint may explain the binge-purging subtype of AN (AN-BP) and the progression into binge-purge and bulimia symptoms, where weight-compensatory behaviours are interleaved with bouts of impulsive and excessive food intake. One such hypothesis is that variation in working memory (WM) capacity contributes to the obsessive, ruminative and inflexible thought patterns that appear to underlie fluctuating cognitive deficits, appetite restraint and body image distortion in restrictive AN (AN-R). There are several cognitive theories regarding how excessive cognitive control is preserved. However, it is important to note that an individual’s diagnosis may change over the course of illness-often referred to as trans-diagnostic. Īlthough the aetiology of AN remains largely unknown, a high degree of cognitive restraint coinciding with perfectionism, rigid thinking styles and obsessive–compulsive cognitions generally set AN apart from other EDs, such as Bulimia Nervosa (BN) and Binge Eating Disorder (BED). The physical and psychological deterioration in AN tragically causes the highest mortality rate of all psychiatric disorders. Alongside the medical complications elicited by long-term starvation, AN patients have a high risk of developing affective disorders, personality disorders and substance use disorders. The disorder typically emerges in adolescent females and is known for its unremitting treatment resistance throughout the individual’s lifetime. It also involves strict monitoring of food intake to control body shape, so-called cognitive restraint. Level of evidenceĪnorexia nervosa (AN) is an eating disorder (ED) characterised by self-induced emaciation, distorted body image and fear of gaining weight. Future studies examining different components of WM, acknowledging these confounding factors, may reveal specific deficits in AN to aid treatment improvement strategies. Comorbidities and psychotropic medications were common among AN participants and should be regarded as critical confounding factors for WM measures. ConclusionĮxamining age groups and WM subsystems separately revealed novel findings of differentially affected WM components in AN. Adults with AN displayed deficits in 44% of the verbal/auditory tasks, while performance remained unaffected in 86% of visuospatial tasks. In 71% of WM tasks, no difference in performance between AN patients and age-matched controls was reported, while 29% of WM tasks showed worse performance. To address these conflicts, 25 studies, published between 20, investigating WM in children, adolescents and adults with AN were systematically reviewed using PRISMA guidelines. Additionally, differential cognitive profiles of restricting versus binge/purging subtypes, comorbid psychiatric disorders and psychotropic medication use may confound findings. Conflicting evidence may be due to heterogeneity of tasks examining different WM components (e.g., verbal/auditory versus visuospatial), and differences in adolescent versus adult AN. Therefore, it seems that visuospatial scratchpad component of working memory might be specifically used for planning and carrying out gait as a motor task.Cognitive restraint has potentiating and deleterious effects on working memory (WM) in anorexia nervosa (AN). The results also showed that in dual task condition, visuospatial scratchpad activation interferes with elderly gait more so than the phonological loop activation. The findings indicated a significant difference between 3 testing conditions in step time, cadence, acceleration amplitude variability and step width. Repeated measure ANOVA was used to analyze the gait parameters. Walking trials were recorded by Motion Analysis system during the test session. The purpose of the present study was to investigate the effect of concurrent cognitive tasks activating phonological loop and visuospatial scratchpad of working memory on gait in older adults.12 older adults with the age range of 65-70 years performed walking trials in 3 counterbalanced testing conditions including single walking, walking while performing visuospatial task and walking while performing phonological task.
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