More than “just a test”—Task-switching paradigms offer an early warning system for cognitive decline

Abstract

Cognitive control processes support goal-directed behavior and flexible adaptation in response to changing contexts. These processes are sensitive to a broad range of biological and environmental impacts, including physical and mental health conditions, substance use, lifestyle choices, as well as adverse personal and social circumstances. Cognitive control processes and associated prefrontal cortical areas are the last to fully mature during young adulthood, and most sensitive to the effects of age in late life. Moreover, cognitive control ability in early life is predictive of adaptive or maladaptive outcomes in adulthood. The sensitivity of cognitive control processes to many of the influences that impact our lives makes them a prime candidate as an early warning system of the need for assessment and intervention to prevent cascading effects of cognitive decline across multiple contexts and areas of functioning. In this paper, we briefly review current approaches to assessing cognitive control literature, with a particular focus on the task-switching paradigm. We briefly review current designs and measures, its link to prefrontal cortical function and its sensitivity to a broad range of clinical conditions and lifestyle variations. We conclude that the task-switching paradigm may provide a sensitive tool for assessing cognitive control ability across the lifespan, as well as detecting early subtle changes in ability that may be predictive of future negative outcomes and signal the need for intervention. We briefly discuss how the task-switching paradigm could be developed into a powerful “canary in the coalmine.”