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Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation

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Abstract and Figures

When a ship grounds in polar regions, evacuees may be required to survive for more than five days before rescue, such that maintaining cognitive performance becomes crucial for survival. Therefore, the purpose of this study was to explore the effects of prolonged cold exposure on cognitive performance. Core temperature (Tc) and cognitive test battery (CTB) performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature). Participants were recruited from those who have regular occupational exposure to cold conditions. Participants were instructed that they could freely engage in minimal exercise that was perceived to aid maintain a tolerable level of thermal comfort. Despite the active engagement, Tc was significantly lower after exposure and the conditions were also sufficient to eliminate the typical 0.5 – 1.0oC circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance occurred regardless of exposure time. Based on the results and similar findings from previous research, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the dual benefit of maintaining metabolic heat production and also improving motivation and acting as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance.
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Research Article
Cognitive Performance during a 24-Hour Cold Exposure
Survival Simulation
Michael J. Taber,1,2 Geoffrey L. Hartley,1Gregory W. McGarr,1
Dessi Zaharieva,1Fabien A. Basset,3,4 Zach Hynes,3Francois Haman,5,6
Bernard M. Pinet,7Michel B. DuCharme,4,8 and Stephen S. Cheung1,4
1Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, 500 Glenridge Avenue,
2Falck Safety Services Canada, 20 Orion Court, Dartmouth, NS, Canada B2Y 4W6
3Department of Human Kinetics and Recreation, Memorial University, St. John’s, NL, Canada A1C 5S7
4Marine and Arctic Survival Scientic and Engineering Research Team (MASSERT), Canada
5School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada K1N 6N5
6Nutrition and Metabolism Research Unit, Montfort Hospital Research Institute, Ottawa, ON, Canada
8Defence R&D Canada, Quebec City, QC, Canada G3J 1X5
Correspondence should be addressed to Michael J. Taber;
Received  February ; Revised  May ; Accepted  May 
Academic Editor: Edward J. Ryan
Copyright ©  Michael J. Taber et al. is is an open access article distr ibuted under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Survivor of a ship ground in polar regions may have to wait more than ve days before being rescued. erefore, the purpose of
this study was to explore cognitive performance during prolonged cold exposure. Core temperature (𝑇c) and cognitive test battery
(CTB) performance data were collected from eight participants during  hours of cold exposure (.Cambientairtemperature).
Participants (recruited from those who have regular occupational exposure to cold) were instructed that they could freely engage
in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test
conditions were sucient to signicantly decrease 𝑇caer exposure and to eliminate the typical .–.C circadian rise and drop
in core temperature throughout a  h cycle. Results showed minimal changes in CTB performance regardless of exposure time.
Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical
activity, which could have the benet of maintaining metabolic heat production, improve motivation, and act as a distractor from
cold discomfort. is recommendation should be taken into consideration during future research and when considering guidelines
for mandatory survival equipment regarding cognitive performance.
1. Introduction
Extreme tourism (i.e., Alaskan and Antarctic cruises) is
melt. As a result of expanding marine trac in polar waters,
there is an increase in the possibility of ships grounding on
areas of previously inaccessible shoreline. Evidence of this
possibility can be seen in the number of incidences reported
by the National Transportation Safety Board (NTSB), the
Transportation Safety Board of Canada (TSB), and various
news agencies. Table  shows that since the Majestic Explorer
rammed into a rocky shoal on the Alaskan shoreline in
, leaving one passenger dead and several others injured,
there have been at least  such events in which passengers
may be faced with the possibility of evacuation into harsh
environmental conditions.
It has been reported that a mass rescue operation in sup-
port of an evacuation of a cruise vessel in Arctic waters would
require approximately ve days to complete []. Although
international regulations mandate the amount of food, water,
Hindawi Publishing Corporation
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Volume 2016, Article ID 8130731, 11 pages
BioMed Research International
T : Cruise ship emergency events by region.
Name of vessel Year Region Evacuation method
Majestic explorer  Arctic Inatable liferas
Nieuw Amsterdam  Arctic Reoated
Star princess  Arctic Evacuated to another ship
Spirit of   Arctic Inatable liferas
Wilderness explorer  Arctic Reoated
Clipper adventure  Antarctica Freed by Chilean icebreaker
Mona lisa  Arctic Evacuated to another ship
Le conte  Arctic Evacuated to another ship
Wilderness adventurer  Arctic Evacuated to another ship
Clipper odyssey  Arctic Coast Guard assistance
Lyubov orlova  Antarctica Transferred to another ship
Nordkapp  Antarctica Transferred to another ship
MV explorer  Antarctica Lifeboats
Empress of the north  Arctic Coast Guard assistance
Spirit of Alaska  Arctic Coast Guard assist/transferred to another ship
Spirit of glacier bay  Arctic Evacuated to Coast Guard vessel
Ushuaia  Antarctica Evacuated to Chilean nav y vessel
Antarctic dream  Antarctica Free by a research vessel
Ocean nova  Antarctica Evacuated to Argentine Navy vessel
Clipper adventurer  Arctic Coast Guard assistance
Clelia II  Antarctica Assisted by NG Explorer
Polar star  Antarctica Evacuated to Argentine Navy vessel
Sea spirit  Arctic Zodiac capsizes during shore excursion
Silver explorer  Antarctica Damaged by ’ large wave
and equipment International Maritime Organization (IMO)
(): guidelines for ships operating in Arctic ice-covered
waters (I:\CIRC\MSC\-MEPC-Circ), these supplies
are only required to last for three days. Previous research,
conducted over signicantly shorter periods, has shown
that cognitive performance is impaired by environmental
thermal stress []. At present, it is not known whether the
cognitive abilities required to perform vital survival tasks
will be diminished during long-term cold exposure, thereby
reducing the possibility of rescue and ultimately survival
from a polar abandonment from ship or air. More specically,
it is not known whether there are measures that can be
employed by the survivors to mitigate the possible decits in
erefore, in an eort to address some of these unknown
aspects of long-term survival in cool conditions, this paper
presents cognitive performance ndings from a -hour
experimental cold exposure protocol in which the partici-
of physical activity (active engagement) required to maintain
a level of performance perceived to be sucient to complete
a series of cognitive tests. Based on previous research and
duration of the exposure, it was expected that the cool
conditions would impair some aspects of cognition (e.g.,
no eect or enhancing other aspects (e.g., reaction time for
simple tasks).
2. Methods
2.1. Participants. e experimental protocol and instrumen-
tation conformed to the standards set by the Declaration of
Brock University (REB -). Participants were medically
cleared (cardiac stress test) by a primary care physician
for any cardiovascular or neuromuscular symptoms and
provided written informed consent prior to taking part in
the study. An inclusion criterion was regular occupational or
recreational experiences with cold exposure, and participants
came from various professional backgrounds.
2.2. Experimental Design. e overriding design goal was
to have participants thermally stressed to near the limits
of voluntary tolerance, complete with mild hypothermia
and shivering activity, for an entire  h without signicant
participant dropout (see [], for more detail). e experi-
mental design was developed to replicate some of the basic
survival conditions that might be expected following vessel
abandonment in the Arctic. For example, there was limited
access to food, water, mental stimulation, and opportunities
to sleep. To simulate the environmental conditions and
emergency supplies that may be available in a lifeboat or life
ra, no blankets or pillows were provided during the single
continuous session of  hours of cold exposure. Participants
were free to stand or sit in the chamber (described below)
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test Groton
test -
questionnaire APM
Before cold exposure CTB
approximate time to
complete =80min
CTB - approximate time to complete =40min
F : Full CTB administration protocol.
when they were not taking part in specic testing procedures.
Prior to beginning and also following the -hour cold expo-
sure, participants performed  min of moderate treadmill
walking at % of their maximal aerobic capacity to simulate
the level of physical exertion and activity that might be found
during evacuation and rescue.
To test cognitive performance, a battery of tests that
explored working and long-term memory, vigilance, absent-
mindedness, general mental capabilities, executive function-
ing, information processing ability, and spatial ability in
visual working memory was presented to participants at six
dierent time points throughout the experimental protocol
sure). Upon arrival on the testing day, participants completed
the cognitive test battery (CTB) as a baseline measure. Aer
exiting the environmental chamber, participants completed a
nal CTB following the postexposure treadmill exercise bout.
e CTB was designed to explore both simple and complex
tasks in an eort to identify where, if any, decits might occur.
ermal comfort and sensation [] were recorded at each
CTB time point.
2.3. Establishment of Ambient Air Temperature Protocol.
Given the limited research associated with long-term expo-
sure, ambient air temperature used for the experimental pro-
tocol was based on pilot testing. Two participants completed
dierent components of the experimental protocol for a
planned  hours, with one additional participant completing
a full  hours of testing. Based on the level of experiences
described by the pilot participants and previous short-term
cold exposure studies [], an ambient air temperature of C
was used for the pilot studies. Body core temperature data
and ratings of thermal comfort were then used to identify the
likelihood that participants would be able to endure/tolerate
experimental test protocol ambient temperature was set at
.  C (see [], for more detail).
2.4. Cognitive Testing. To reduce the likelihood of a learning
eect inuencing the results collected during the actual
administration of the CTB, a familiarization session was
conducted several days prior to the cold exposure. is
familiarization session gave participants the opportunity to
practice sections of the CTB and ask questions about the test
As no previous research exploring cognitive performance
during prolonged cold exposure exists, specic cognitive tests
were selected to explore the inuence of exposure on complex
information processing requirements that might be used
of cognitive self-evaluation and general uid intelligence
(Gf), participants completed a cognitive failure question-
naire (CFQ) [] and Ravens Advanced Progressive Matrices
(APM) []  hours before entering the environmental cham-
ber. ese two tests were not completed aer the exposure, as
administration []. For example, Bridger et al. [] reported
a test-retest reliability of . for CFQs completed at  and
 months aer the original administration of the test. Given
the relatively short time period ( hours) between the
two test periods, it was expected that the participants would
remember how they had responded on the initial (pretest)
CFQ and Ravens APM.
To establish a measure of progressive changes throughout
ing test (GMLT) [], two-back tests (TBT), and mental
rotation tasks (MRT) at predetermined intervals ( h,  h,
 h, and  h) beginning  min aer initial cold exposure
(Figure ). ese measures were also compared against
pre/postexposure scores. e GMLT and TBT are part of the
psychometric measures available from CogState [] and have
been reported to correlate well (𝑟’s = .–.) with similar
eects [].
is combination of tests in this integrated CTB has
not been used before for cold exposure research; however,
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all of the measures have been examined for reliability and
validity in previous cognitive performance studies [, , ].
e following description of each test outlines the areas
of cognitive function believed to be important to decision
making in a survival situation.
Cognitive Failure Questionnaire (CFQ). e CFQ is a -item
questionnaire that represents self-reported cognitive perfor-
mance. e CFQ is measured as a total score ranging from
 to  and is related to four factors of absentmindedness
(memory, distractibility, blunders, and names). In addition,
the CFQ items explore aspects such as spatial orientation
failures, memory lapses, and motor functioning. Items are
scored on a -point Likert scale where  equals “never”
and  equals “very oen.” With high CFQ scores (scored
above ), it would be expected that participants may
have considerable diculties completing tasks that require
vigilance (e.g., ANT, Groton maze, and two-back tasks)
in a prolonged cold exposure environment. e CFQ has
been reported to have Cronbachs alpha value of . and
between  and  [].
Ravens Advanced Progressive Matrices (APM).eAPM
is a nonverbal assessment tool designed to measure gen-
eral mental capabilities pertaining to observational skills,
decision-making, problem identication, perception, and
sense making []. A total of  design puzzles with one
piece missing are arranged in an ascending order of diculty
and raw APM scores have been used as an indicator of uid
intelligence [, ]. Individuals are asked to select one of four
possible choices that follow puzzle design pattern rules. For
the purposes of obtaining a baseline measure of cognitive
ability, the APM was completed without a time limit [].
Attention Network Test (ANT). e ANT is a psychometric
tool used to test the eciency of three distinct components
of the human attention network (i.e., alerting, orienting, and
executive control). e test is a combination of a anker task
with arrows and a reaction time task (for a full description
of the test administration methods see [, ]). e ANT
was selected for use during the cold exposure testing as
it has been shown that executive functioning is impaired
when core temperatures are reduced []. Reliability tests for
consecutive ANT performance have shown that a learning
eect exists for the executive functioning, as individuals
progressively get better at ignoring incongruent signals [].
has no eect on cognitive functioning, reaction times should
improve each time the test is administered. As the ANT was
found to be too onerous during preliminary pilot testing, it
was only administered during the pre-, -hour, -hour, and
posttesting sessions. Ishigami et al. [] suggest that “overall
RT is itself correlated with age (𝑟=.),thenet-work[sic]
scores (𝑟=.and.fortheorientingandexecutivescores,
resp.; ns for the alerting scores), and also with the process
scores (ranging from 𝑟=. to .; ns for processes of
Divided attention and Verbal monitor- ing [sic])” (p. ).
Groton Maze Learning Test (GMLT).eGMLTisa
computer-based neuropsychological measure (Cogstate, New
Haven, CT) of working memory functioning (measured by
the maze eciency index) and information processing ability
or executive functioning (measured by the number of errors)
[]. e test consists of a  × grid of square tiles (covering
a hidden pathway –  moves including  turns) presented
to individuals on a touch screen computer surface. When
presented to a participant, the GMLT is randomly selected
from a test bank of  dierent versions of the maze, with
each one equivalent in diculty. Completing one test does
not prepare the individual for subsequent GMLT, therefore,
avoiding a learning eect between tests []. For each CTB
session, the GMLT is presented six times (ve initial repeated
trials and one delayed recall requiring approximately  to
CTB sessions to test working memory). Trials were timed
(ms) and began automatically when the rst move is made
on the learning trial.
Two - B ack Task (TBT). Similar to the GMLT, the two-back
task (TBT) is a computer-based measure of visual working
memory and attention (CogState, New Haven, CT). e TBT
presents a playing card, shown face up, in the middle of a
screen. Individuals are asked to decide (select “yes” or “no”)
whether a presented card is identical to one shown two cards
before. An interstimulus interval of  seconds is used between
the presentations of  cards. CR selected either the “d”
(no) or “k” (yes) button on a standard QWERTY computer.
Errors on the TBT have been reported to have a signicant
correlation with errors on the GMLT.
Mental Rotation Task (MRT).eMRTconsistedofa
computer-based (available at)
test of spatial ability in which an individual is given a number
of visual choices that represent a rotated version of a master
image. e master image consisted of small squares arranged
into a pattern presented in an upright position. Each possible
choice contains the same number of small squares; however,
they are arranged in slightly dierent patterns (with the
exception of one correct choice). Diculty in selecting the
correct match to the master image is created by rotating each
of the choices a specic number of degrees to the le or right
(e.g., or ). e MRT was selected to explore the
capability to maintain an understanding of spatial orientation
of objects, which was believed to be important during the
nal stages of search and rescue operations (e.g., direction of
aircra in relationship to signaling devices).
2.5. Data Analysis. All data were examined with IBM SPSS
(version ) soware. Prior to performing the statistical
analysis for hypothesis testing, the data were plotted to check
for errors and outliers. Additional checks were performed to
test for the assumptions of normality (Shapiro-Wilkes test)
and homogeneity of variance (Levenes test). Data collected
from each of the CTB were compared for each of the
dependent variables in a within and between subject design.
Specically, responses for each test were compared across
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T : Participant demographic and physiological information.
Participant Measure
Age Height (cm) Weight before (kg) Weight aer (kg) % body fat USG before USG aer ̇
VO2max (mL/min/kg)
 . . . . . . .
  . . . . . 
 . . . . . 
 . . . . . .
 . . . . . . .
 . . . . . .
  . . . . . .
 . . . . . . 
Mean . . . . . . .
(SD) (.) (.) (.) (.) (.) (.) (.)
T : Participant cold exposure experience.
Participant Cold exposure experience
Years of experience Coldest temperature (C) Duration of exposure (hours) Last exposure
  Within last  months
  Within last  months
 Within last  months
 Within last  months
 Within last  months
 Within last  months
  Within last  months
Did not respond to questionnaire
Mean . . 
(SD) . . .
the dierent time points for each participant to identify
possible changes. ese responses were also combined for
all participants to identify general trends in the data based
on the amount of exposure time. Repeated measures analysis
of variance (ANOVA) was used to explore changes in CTB
score for each test. Post hoc analyses were carried out where
appropriate and alpha levels were adjusted according to
Bonferroni corrections.
3. Results
3.1. Initial Cognitive Assessment (CFQ and Raven’s APM). e
results from the CFQ and Raven APM were used as measures
of standardized cognitive processing. Due to known learning
eects, these tests were only performed at baseline and were
(SD = .) (within the normal range for North American
population) and all recorded CFQ scores fell within the %
condence interval []. e untimed administration of the
Raven APM scores ranged from  to  with a mean of .
(SD = .). e scores were found to be normally distributed
and based on standardized norms for a North American
population []; the scores range from the th to >th
3.2. Responses to Exposure. Given the intense nature of
the applied research setting, participant sample size varied
throughout the test protocol based on voluntary dropout.
Tables  and  provide participant demographic information
as well as an overview of previous occupational or recre-
sion criteria were designed to limit the dropout rate, these
uctuations in sample size reect situation in which it might
a commercial airliner or cruise ship some individuals may not
survive until rescue arrives.
Given that the participants were recruited for their
past experience, Table  details the relevant cold exposure
information. From the table it can be seen that on average
the participants have more than  years of cold exposure
experience in temperatures ranging from CtoC.
SubjectRatingofDiculty. On a subjective rating of dif-
culty where zero represented not dicult at all and 
represented extremely dicult/need to withdraw from the
study, participants rated the experience as an . Seven of
the eight (%) individuals indicated that there was at
least one point throughout the trial that they believed they
would have to voluntarily withdraw from the testing. Two
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of the participants voluntarily removed themselves from the
experimental protocol—one at .h and the other at  h.
CTB results include the scores of these two participants for
the period in which they remained in the trial (i.e., during the
baseline and rst  hours). Another participant performed
were suciently taxing physically and mentally even for
this motivated and self-selected participant pool. Seven of
eight participants reported minimal sleep (. h) over the
 hours. None of the participants found the bedspace to be
a safe haven or comfortable, and most declined to use the
bedspace or prematurely removed themselves from it over the
course of cold exposure.
Core Temperature (𝑇c). No participants were removed from
the experiment due to core temperature reaching .C,
though two participants used the thermal blanket at various
points throughout the testing. For most participants, core
temperature generally decreased .C (SD = .) within the
rst  h of exposure and then stabilized at that approximate
level for the remainder of the -hour exposure. Fluctuations
within a range of .C occurred during this latter “stable
period, but overall the participants were able to suciently
ment of mild exercise. Overall, this drop in core temperature
was found to be signicant (𝐹(4,32) =.,𝑝<.),
with a .C(SD=.)dropincoretemperaturebetween
and  hours of exposure). A similar examination of both
thermal comfort and sensation did not reveal any signicant
dierences across the  hours of exposure. Importantly,
the thermal exposure also eliminated the typical .–.C
circadian rise and drop in core temperature throughout a -
hour cycle [], such that the true level of hypothermic strain
exceeded the .Cabsolute𝑇cdecrease for much of the
ANT Results. e individual mean scores of the three net-
works: alerting, orientation, and conict, were .ms (SD
= .), . ms (SD = .), and . ms (SD = .),
respectively. e mean total reaction time for correct trials
was . ms (SD = .). e test was administered at four
dierent time point: before cold exposure;  hours;  hours,
there were no signicant dierences between scores based on
administration time for alerting, orientation, or conict. No
signicant dierences in total mean reaction time were found
for any of the test blocks.
GMLT Results.AspartofthecomputerizedCogStateportion
of the CTB, the GMLT was completed a total of six times
and aer). Given the test protocol, individual GMLT were
presented to the participant seven times (initial test sequence,
ve consecutive presentations, and one recall presentation
aer completing the TBT). Aer the initial presentation, the
nal maze in the initial block (Test Code GMLT-) error rate
was compared with the recall maze (Test Code GMLT-R)
Total errors
Test code
Tcore (C)
F : Total GMLT error based on GMLT- and GMLT-Recall
mean 𝑇cof participants at the time of completing the recall GMLT.
using a Wilcoxon Signed Rank Test. No signicant changes
in performance were noted across the trials. However, when
comparing the same two presentations of the Groton maze
for the postexposure session, the results indicate that there
was a signicant dierence between the number of errors
committed (𝑍=., 𝑝= .). Figure  shows that
almost all of the participants committed more errors while
completing the recall GMLT during the postexposure CTB
session. No other signicant ndings were found.
TBT Results. e two-back task was administered during the
same time points as the GMLT. A repeated measures ANOVA
and number of errors. No signicant ndings were found
regardless of trial administration time.
MRT Results.ementalrotationtask(MRT)measuredthe
test block. Table  displays the mean reaction time (RT) and
accuracy for each of the test blocks.
reduction in MRT accuracy (𝑛=,𝑝=.).Posthoc
analyses indicated that the signicant dierence occurred
between rst test aer beginning the exposure ( h) and aer
 h of exposure (Figure ). Posttest results indicate that when
completing the computer-based MRT, participants did not
require signicantly more time or commit more errors when
compared to the pretest MRT. Results further indicated that
pretest and posttest computer-based MRT correlate well with
one another (𝑟(6) =.,𝑝= .). No other signicant
BioMed Research International
T : Mean (SD) reaction times and accuracy for the MRT based
on test blocks.
Test scor e Test block (hour)
Before     Aer
Reaction time
(ms) (SD)
. 
. 
(number of
Accuracy (number of errors)
12 hours
18 hours
24 hours
F : MRT errors committed by each participant across all
ndings were found for speed or accuracy regardless of the
time at which the test was completed.
3.3. Combined Cognitive Eects. is section of the results
addresses some of the combined eects of the experimental
conditions on cognitive performance. Correlation analyses
reveal that there were several signicant relationships that
existed within the CTB results; however, no eect of time was
found for performance. Table  displays the correlation table
for all of the tests as they relate to one another.
4. Discussion
cold environment. e primary goal was to elicit a sus-
tained moderate thermal stress throughout  h, including
a decrease in core temperature and elevation in metabolism
through shivering. Additionally, we simulated many of the
attendant situational factors, including isolation, boredom,
food quality and availability, and sleep restriction. Rather
than the restricted movement or voluntary physical activ-
ity in traditional hypothermia research, we permitted self-
engaged physical activity within the connes of the testing
chamber to replicate what might occur in a survival scenario.
Overall, despite these challenging experimental conditions
(conrmed by the participant diculty ratings), cognitive
performance (measured by the CTB) did not signicantly
alter throughout the course of the prolonged  h of cold
exposure compared to baseline values taken before cold expo-
sure. Together, this suggests that cognitive performance may
be maintainable through sustained cold exposure, assuming
that severe hypothermia can be avoided.
Despite previous cold exposure research showing a decre-
ment in simple and choice serial reaction times, memory,
sustained vigilance, and target tracking [–], others have
opportunity to self-regulate the amount of protective clothing
worn or where exercise is used during the exposure sessions.
For example, Slaven and Windle [] showed that there were
no signicant decreases in cognitive performance in serial
RT, Sternberg one-letter or seven-letter recall accuracy or
testing in which the ambient air temperature was C,
.C, .C, and .C (resp.) and participants were able to
select between three options of thermal protection. Similarly,
Banderet et al. [] found that over a ve-day cold exposure
session (ambient air temperatures ranged from Catnight
to C during the day) which included physical activity,
signicant dierences in cognitive performance were only
found for individuals who were hypohydrated at or below
.% of total body weight. In addition to the Slaven and
Windle [] and Banderet et al. [] studies within an
applied setting, Baddeley et al. [] suggest that the lack of
changes in cognitive performance found during exposure to
.C water for approximately  minutes was due to highly
motivated divers. Exposure times for all of these studies were
considerably less than those carried out in this examination
of cognitive performance.
Flouris et al. [] show deterioration of vigilance and
reaction time within the rst  minutes of exposure to
C ambient air temperature, while a meta-analysis of
cold exposure studies revealed that cognitive performance is
[]. Meta-analyses [, ] have identied thermally induced
reductions in cognitive performance that are most oen
observed when tasks are highly complex, require sustained
vigilance, and place a considerable load on working memory.
However, within these studies, the decrements to cognitive
performance have been limited to specic domains such as
working memory and vigilance [], while eects have also
been shown in long-term memory recall [].
e disparity in research ndings on the eects of cold-
induced changes in cognitive performance has previously
been explained by suggesting that the environmental stimuli
(hot or cold ambient temperatures) act as a distractor [,
, ] or as form of arousal [, ]. Based on the results
from each of the cognitive tests, it appears that cognition was
BioMed Research International
T : Correlation table for CTB administration.
CFQ APM Alerting Orientation Conict ANT
CFQ score
Pearson correlation
Sig. (-tailed)
APM score
Pearson correlation .
Sig. (-tailed) .
ANT alerting
Pearson correlation . .
Sig. (-tailed) . .
ANT orientation
Pearson correlation . . .
Sig. (-tailed) . . .
N  
ANT conict
Pearson correlation . . . .
Sig. (-tailed) . . . .
N   
ANT reaction time
Pearson correlation . . . .∗∗ .∗∗
Sig. (-tailed) . . . . .
N    
GMLT total errors
Pearson correlation . . .. . .
Sig. (-tailed) . . . . . .
N     
MRT speed
Pearson correlation . . . . . . .
Sig. (-tailed) . . . . . . .
N     
MRT accuracy
Pearson correlation .. . . . . . .∗∗
Sig. (-tailed) . . . . . . . .
N      
Correlation is signicant at the . level (-tailed).
∗∗Correlation is signicant at the . level (-tailed).
not signicantly aected when examining overall changes
during the long-term exposure. Given the paucity of ther-
moregulatory research assessing cognitive performance in
long-term (more than  hours) cold exposure, it is interesting
to note that Pilcher et al. [] and Pietrzak et al. [] reported
that high intensity/short-term exposure had a greater neg-
ative inuence on performance than less intense/long-term
exposure during testing. ese ndings have been supported
by research suggesting that cognitive performance above
ambient temperatures of approximately Cwillhavemin-
imal or no changes, whereas ambient conditions below this
temperature result in deleterious eects []. Finally, Færevik
et al. [] reported that minimal physical activity can be
used to minimize a reduction in core temperature over long-
term cold exposure ( hours). Together, this suggests that
there exists a zone of optimal cognitive performance from
BioMed Research International
maintaining thermoneutrality, similar to that suggested by
Hanin [] and the extended-U hypotheses proposed by
Hancock and Warm []. Both models suggest that there
is a specic zone in which individuals will perform at
maximal levels; however, performance becomes degraded if
individuals are expected to perform tasks outside this optimal
zone. ermal stressors that do not increase the level of
arousal beyond the optimal zone should, therefore, not be
expected to adversely aect the performance of skills that are
well rehearsed or require minimal cognitive eort.
One explanation for the limited changes to cognitive
performance in this study is believed to be the amount of mild
exercise performed by the participants and it was noted that
individuals generally stood throughout the entire experimen-
tal protocol, indicating that it was too cold to sit for any length
of time. It was observed throughout the cold exposure trials
that participants would engage in mild physical activity such
as hopping in one spot, swinging arms around their torso
in a hugging motion, or vigorously rubbing their limbs aer
every test session that required them to sit for any period
of time. Færevik et al. [] showed that minimal exercise in
cold conditions aects core temperature, suggesting that “-
min periods of moderate cycling leg movements every  min
reduced shivering intensity, improved heat balance, slowed
perception of thermal comfort and reduced cold sensation”
(p. ). Specically, in an eort to explore the eects of
exercise on body core while in water, Færevik et al. []
reported that, in Cambientair,
waves, participants rate of core cooling was signicantly less
when they performed moderate (sustainable) cycling for 
minutes every  minutes. In fact, it was reported that not
only did the moderate exercise decrease the rate of core
cooling, it also signicantly increased heat production to the
point that a % gain was observed [].
A second explanation for the results may be related to
the experimental design of the project and appear to support
previous research suggesting that minimal or no dierences
in cognitive performance should be expected when the
intensity of the stressor (the cold ambient air in this case)
they describe that choice RT tests and short-term memory
were unaected aer seven days in a simulated submarine
in distress at .C. Similarly, Giesbrecht et al. [] showed
no signicant dierence in the performance of simple tasks
based on cold exposure. Enander [] noted that there were
no decrements in simple RT tasks when participants were
exposed to C ambient air temperature over a period of  to
 minutes (see also []). Participants in this prolonged cold
activity that would help them stay warm enough to endure
the full -hour exposure protocol. Despite the initial drop in
core temperature, this active engagement potentially provides
a coping mechanism during the testing and possibly could
equate to a survival advantage in abandonment. ere did not
appear one denitive change in cognitive performance over
the course of the experimental session. For example, there
was no dierence in attention related results (ANT and TBT),
while there was a minor (nonsignicant) shi (more errors)
in the working memory aer  hours of exposure, and MRT
results showed that, at  and  hours, there was a tendency
for the participants to require more time to complete the
questions and committed more errors (also not found to be
ndings is related to the level of stimulation present through
the experimental session. e results might suggest that the
level of arousal associated with the cold ambient air, con-
stant shivering, cognitive testing, limited sleep, and conned
conditions fell within an optimal zone of functioning for the
selected group of participants [, ]. e only exception to
this argument of the conditions falling within the optimal
zone was found for the MRT errors. It is possible that the
signicantly higher number of errors in the MRT (when
compared to the performance at  hours of exposure) could
suggest that the level of arousal in the initial part of the testing
was sucient to inuence the performance. As previously
mentioned, the group of participants was specically selected
for this study to ensure a high success rate of completion.
It may be that the intensity of the experimental protocol
was ideally suited to provide a tolerable level in which
performance was not aected []. For example, the ANT
results were consistent with values reported by Weaver et al.
[] who found an overall mean reaction time (RT) of .
(SD = .), an alerting mean score of . (SD = .),
orienting mean score of . (SD = .), and conict mean
score of . (SD = .).
e results indicated that there were signicant corre-
lations between a number of the CTB measures. Given the
specic cognitive tests used in this study and the reported
validity, it would be expected that there would be strong
correlations between and within particular components of
changes occurred in the latter portion of the prolonged
exposure. Given the fact that no time related correlations
(e.g., negative relationship) were found, it can be assumed
that the participants were suciently stimulated to overcome
the expected inuence on fatigue.
4.1. Main Contributions. As the majority of previous cold
exposure research is conducted over considerably shorter
periods of time (e.g., < hours), the primary contributions
from this study are related to the extension of cognitive per-
formance data over a much longer time frame. Additionally,
the novel experimental protocol, which allowed individuals
to actively engage in mild exercise, situates the data in more
realistic conditions. For example, unless injuries preclude
movement and assuming normothermic core temperatures
as seen in this study, it is unlikely that survivors of a vessel
abandonment will passively sit in one position while they
continue to cool to the point that they no longer have the
capability to help themselves.
4.2. Limitations. With no other changes despite a slight
decrease in core temperature, constant shivering throughout
 BioMed Research International
the exposure period, lack of sleep, and minimal food, it could
be argued that it would be dicult to explain which factor(s)
allowed participants to remain at a nearly constant level of
cognitive performance. e limited number of participants
tested in this study and the changes, both positive and
negative depending on the type of measure, may have been
other factors. Additionally, the individual dierences in the
responses to the GMLT may have obscured the eects of
the cold response. Signicant changes may also have been
mediated by increased arousal levels associated with the
distractive nature of the cold exposure [].
4.3. Conclusions. In summary, despite a realistic survival
simulation involving  hours of prolonged cold exposure,
moderate decreases in core temperature, and sustained shiv-
ering, cognitive performance was largely maintained. is
survivors may be capable of maintaining a range of simple
through complex cognitive tasks for at least the rst 
hours of abandonment. One potential contributor to this
performance maintenance may be the allowance of mild, self-
maintaining core temperature and also improving motivation
and acting as a distractor from the cold discomfort.
Competing Interests
e authors declare that there is no conict of interests
regarding the publication of this paper.
e authors are indebted to the participants for their spirit
and enthusiasm throughout the study. e project was funded
by a grant from the National Search & Rescue Secretariat
(SAR New Initiative Fund supported by Transport Canada)
through a contract from Public Works & Government Ser-
vices Canada (Solicitation no. -/A) and a grant
from the Natural Sciences & Engineering Research Council
of Canada (no. -, S. S. Cheung). M. J. Taber was
supported by a Ministry of Research and Innovation Post-
Doctoral Fellowship, and S. S. Cheung was supported by
a Canada Research Chair. C. van Nijen assisted with data
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... Cognitive ability is crucial to respond to challenging situations and preserve personal safety [36] as cold environs elicit decrements in decision making [37] and reaction time [16,38] which lead to increased injury risk. However, Taber et al. [39] reported no significant differences in cognitive ability after cold exposure, although participants in Taber et al. [39] were highly experienced in colder temperatures, which may have influenced the study's findings. It is not clear if individuals not habituated to cold environments are more vulnerable to cognitive deterioration. ...
... Cognitive ability is crucial to respond to challenging situations and preserve personal safety [36] as cold environs elicit decrements in decision making [37] and reaction time [16,38] which lead to increased injury risk. However, Taber et al. [39] reported no significant differences in cognitive ability after cold exposure, although participants in Taber et al. [39] were highly experienced in colder temperatures, which may have influenced the study's findings. It is not clear if individuals not habituated to cold environments are more vulnerable to cognitive deterioration. ...
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Background: Perceived exertion is an acknowledged indicator of exercise intensity and homeostasis disturbance of an individual, however, there are few studies that have examined the influence of cold temperatures on perceived exertion measurements. Cognition is crucial to perception and exposure to cold temperatures can elicit decrements in cognition. Aims & Objectives: The aim of this study was to determine if, and to what extent, exposure to cold environments may influence perceived exertion and cognitive ability. Study Design: Randomised controlled trial. Materials & Methods: Sixteen participants (m= 8, f= 8, age: 22.3 ± 1.7 years (mean ± SD)), completed two trials in a randomised order in COLD (5°C) and CONTROL (18 °C, 55% relative humidity) conditions. During each trial, following a standardised warm up, participants performed a 6-minute cycle ergometer submaximal exercise. Cognitive ability was assessed pre and post exercise with a reaction time (RT) test. Participant’s physiological responses were measured using Rate of Perceived Exertion (RPE), Heart Rate (HR), Oxygen consumption (VO2), Minute Ventilation (VE), Tympanic (Tt) and Skin Temperature (Tsk) continuously during testing. Statistics: Two-way repeated measures Analysis of Variances (ANOVA), were between environmental conditions over time. Data are reported as mean (M) ± standard deviation (SD). Ordinal Friedman ANOVA tests were conducted on RPE data between environmental conditions and gender. Non-parametric descriptive statistics were reported as medians (Mdn) and inter-quartile ranges (IQR) (25th – 75th Percentile). Statistical significance was accepted at p < 0.05. Results: There was no significant difference (p > 0.05) reported in RPE, VO2 and VE between COLD and CONTROL groups, however, significant decreases in Tsk (p = 0.001) and Tt (p = 0.001) were observed in COLD compared to CONTROL groups. Additionally, no significant differences (p > 0.05) in RT occurred between COLD and CONTROL. Furthermore, no significant differences in RPE were established between genders. Conclusions: Short-term exposure to cold temperatures does not significantly affect physical exertion perception or cognitive ability.
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The aim of this study was to analyze nutritional habits of well-trained alpinists during a standard ski mountaineering tour. Therefore a sample of eighteen male ski mountaineers (25 ± 5.8 years, 73.2 ± 6.1 kg, 180.2 ± 6.8 cm) were questioned after absolving a typical ski mountaineering tour e.g. Finsterarhorn 4274 meter (Cantone Bern); Gross Ruchen 3183 meter (Cantone Glarus); L'aiguille de la Tsa 3668 meter (Cantone Wallis). It was detected, that nutritional habits differed widely. From bread to meat and chocolate a broad range of nutritionals were consumed. Interestingly, despite the physiological demands special sports nutrition such as gels or special sport bars were not widely used. Lots of alpinists also consumed fruits or dried fruits such as apples or dried apricots. Interestingly, only one person paid special attention to salt intake. Fluid intake seemed with an average of 1.39 ± 0.68 liter per tour relatively low. This was probably also due to the aim of reducing backpack weight allowing to faster reach the peak while increasing security. Due to the low fluid intake Alpinists are encouraged to be well hydrated when starting and to drink sufficiently after finishing tours, especially when tours of several days are absolved a fast rehydration improves recovering and reduces risks of accidents in further tours in the following days. Keywords: Alps; Nutrition; Ski mountaineering; Fluid intake.
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As the majority of cold exposure studies are constrained to short-term durations of several hours, the long-term metabolic demands of cold exposure, such as during survival situations, remain largely unknown. The present study provides the first estimates of thermogenic rate, oxidative fuel selection and muscle recruitment during a 24 hours cold survival simulation. Using combined indirect calorimetry, electrophysiological and isotopic methods, changes in muscle glycogen, total CHO, lipid, protein oxidation, muscle recruitment and whole body thermogenic rate were determined in underfed and non cold-acclimatized men during a simulated accidental exposure to 7.5°C for 12 to 24 h. In non cold acclimatized healthy men, cold exposure induced a ~0.8°C decrease in core temperature and a ~6.1°C decrease in mean skin temperature (range 5.4-6.9°C). Results showed that total heat production increased by ~1.3-1.5-fold in the cold and remained constant throughout cold exposure. Interestingly, this constant rise in and shivering intensity was accompanied by a large modification in fuel selection occurring between 6 and 12 h; total CHO oxidation decreased by 2.4-fold and lipid oxidation doubled progressively from baseline to 24h. Clearly, such changes in fuel selection dramatically reduces the utilization of limited muscle glycogen reserves, thus extending the predicted time to muscle glycogen depletion to as much as 15 days rather than the previous estimates of ~30-40 h. Further research is needed to determine whether this would also be the case under different nutritional conditions and/or under colder conditions.
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The Attention Network Test (ANT) is a frequently used computer-based tool for measuring the three attention networks (alerting, orienting, and executive control). We examined the psychometric properties of performance on a variant of the ANT, the Attention Network Test-Interaction (ANT-I) in healthy older adults (N = 173; mean age = 65.4, SD = 6.5; obtained from the Brain in Motion Study, Tyndall et al. BMC Geriatr 13:21, 2013. doi: 10.1186/1471-2318-13-21) to evaluate its usefulness as a measurement tool in both aging and clinical research. In terms of test reliability, split-half correlation analyses showed that all network scores were significantly reliable, although the strength of the correlations varied across networks as seen before (r = 0.29, 0.70, and 0.68, for alerting, orienting, and executive networks, respectively, p's < 0.05). In terms of construct validity, ANOVAs confirmed that each network score was significant (18.3, 59.4, and 109.2 ms for the alerting, orienting, and executive networks, respectively, p's < 0.01) and that these scores were generally independent from each other. Importantly, for criterion validity, a series of hierarchical linear regressions showed that the executive network score, in addition to demographic information, was a significant predictor of performance on tests of conflict resolution as well as verbal memory and retrieval (β = -0.165 and -0.184, p's < 0.05, respectively). These results provide new information regarding the reliability and validity of ANT-I test performance in a healthy older adult population. The results provide insights into the psychometrics of the ANT-I and its potential utility in clinical research settings.
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With the aging of the population, the possibility of the occurrence of cognitive decline rises. A number of types of intervention seek to attenuate or reverse this impairment. The use of computerized tests helps quantify the effects of interventions on cognitive function in the elderly. The objective of the present review was to analyze studies that have utilized computerized cognitive tests to determine the effects of interventions in the elderly population, describing the batteries and tests employed, the populations studied and reports by authors on the limitations or benefits of employing these tests in older adults. The review was performed on the PubMed database using the descriptors: cognitive computerized test and elderly. We retrieved 530 studies and, following analysis of their abstracts, selected 32 relevant to the subject. The studies utilized 19 different types of computerized tests and batteries to assess the interventions, which were predominantly drug trials. There were no reports on limitations in the use of the computerized tests, suggesting this type of intervention had good applicability, sensitivity, and little or no practice effects in this population.
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Unlabelled: The Cognitive Failures Questionnaire (CFQ) is used in ergonomics research to measure behavioural problems associated with attentiveness and memory in everyday life. CFQ scores have been related to constructs such as accident proneness and outcomes such as human error and psychological strain. The two-year test-retest reliability of the CFQ is reported together with the findings of factor analyses of CFQ data from 535 respondents. Evidence for the predictive and criterion validity and internal reliability of the CFQ is provided. Psychological strain was measured concurrently with CFQ on both testing occasions, two years apart. The test-retest reliability of the summated CFQ score was found to be 0.71, while for the General Health Questionnaire (GHQ-12) strain measure it was 0.32.The relative variance stability was five times greater for the CFQ than the GHQ, indicating that scores on these questionnaires are not covariates. The use of the CFQ as a measure of cognitive control capacity is also discussed. Practitioner summary: Ergonomists have long been interested in human error and the role of high work demands due to poor equipment design and excessive workload. The CFQ measures attentiveness in daily life and is shown to have excellent psychometric properties that make it suitable for use in both laboratory and field studies as a trait measure of attentiveness in daily life.
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Five hundred and six first-year university students completed Raven's Advanced Progressive Matrices. Scores on Set II ranged from 6 to 35 (M= 22.17, SD = 5.60). The first 12 items of Set II were found to add little to the discriminative power of the test. Exploratory and confirmatory factor analyses failed to confirm Dillon et al.'s two-factor solution and suggested that a single-factor best represented performance on Set II. A short-form of Set II, consisting of 12 items extracted from the original 36, was developed and found to possess acceptable psychometric properties. Although this short form differed considerably in content from the short form previously devised by Arthur and Day, the two short forms did not differ with respect to concurrent validity and predictive power.
Volunteers′ body core temperatures were lowered by immersion in water at 15 degrees C. Aspects of cognitive function were subsequently tested after rewarming had been started in water at 41 degrees C when their skin was warm and they felt comfortable but their body core temperature remained low. Memory registration was found to be impaired progressively when core temperature fell from about 36.7 degrees C; at core temperatures of 34-35 degrees C the impairment caused loss of approximately 70% of data that could normally be retained. However, recall of previously learned data was not impaired at these core temperatures. On a two-digit calculation test, speed of performance was impaired by about 50% at a core temperature of 34-35 degrees C, but provided enough time was available, accuracy of performance was not reduced.
This paper focuses on the link between the scores obtained for the Cognitive Failure Questionnaire and those obtained from cognitive inhibition tasks. The fact that a self-report of cognitive lapses in everyday functioning, which requires subjects to make only very approximate ordinal judgements of relative incidence, is linked in a very significant way to some laboratory measures of performance, is both an originality within cognitive psychology studies and a valuable indication of the validity of this instrument. If we take the overall results, it would therefore seem reasonable to consider that CFQ is linked to some fairly general trait related to the ability to attend to focal stimuli while simultaneously ignoring task-irrelevant distractions (i.e. a selective attention ability).
The aim of the study was to investigate prospective associations between dietary patterns and cognitive performance during adolescence. Participants were sourced from the Western Australian Pregnancy Cohort (Raine) Study that includes 2868 children born between 1989 and 1992 in Perth, Western Australia. When the children were 17 years old (2006-2009), cognitive performance was assessed using a computerized cognitive battery of tests (CogState) that included six tasks. Using a food frequency questionnaire administered when the children were 14 years old (2003-2006), 'Healthy' and 'Western' dietary patterns were identified by factor analysis. Associations between dietary patterns at 14 years of age and cognitive performance at 17 years of age were assessed prospectively using multivariate regression models. Dietary and cognitive performance data were available for 602 participants. Following adjustment for the 'Healthy' dietary pattern, total energy intake, maternal education, family income, father's presence in the family, family functioning and gender, we found that a longer reaction time in the detection task (β = .016; 95% CI: 0.004; 0.028; p = .009) and a higher number of total errors in the Groton Maze Learning Test - delayed recall task (β = .060; 95% CI: 0.006; 0.114; p = .029) were significantly associated with higher scores on the 'Western' dietary pattern. The 'Western' dietary pattern was characterized by high intakes of take-away food, red and processed meat, soft drink, fried and refined food. We also found that within the dietary patterns, high intake of fried potato, crisps and red meat had negative associations, while increased fruit and leafy green vegetable intake had positive associations with some aspects of cognitive performance. Higher dietary intake of the 'Western' dietary pattern at age 14 is associated with diminished cognitive performance 3 years later, at 17 years.
Sixty-seven participants (39 men and 28 women), ranging in age from 26 to 79 years, were administered Raven's Advanced Progressive Matrices (APM) on three occasions. Although total APM scores were found to be highly reliable across the three occasions, the reliabilities of most individual items were extremely low. A single-factor model remained a borderline adequate fit (explaining approximately 20% of the variance) for the interitem correlation matrix on all three occasions. Total APM scores increased significantly across the three occasions (approximately two items per occasion). Improvements in total score across the occasions happened within a context of subjects changing both correct and incorrect responses from the previous occasion. The number of items left unanswered was found to be unrelated to both APM score on any given occasion and the amount of gain in score made across occasions. These findings suggest that the improvements in performance were not based on the acquisition of a strategy design to respond to more items or on the retention of item-specific information, but rather, the improvement reflected learning, something common to the types of items found in the APM.