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Abramowitz A, Weber M. Management of MCI in the Outpatient Setting. Curr Psychiatry Rep 2024:10.1007/s11920-024-01514-3. [PMID: 38856858 DOI: 10.1007/s11920-024-01514-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE OF REVIEW We review current literature related to the clinical assessment of Mild Cognitive Impairment (MCI). We compile recommendations related to the evaluation of MCI and examine literature regarding the use of clinical biomarkers in this assessment, the role of non-pharmacologic therapy in the prevention of cognitive decline, and recent approval of anti-amyloid therapy in the treatment of MCI. RECENT FINDINGS The role of imaging and plasma biomarkers in the clinical assessment of MCI has expanded. There is data that non-pharmacologic therapy may have a role in the prevention of neurocognitive decline. Anti-amyloid therapies have recently been approved for clinical use. Clinical assessment of MCI remains multifactorial and includes screening and treating for underlying psychiatric and medical co-morbidities. The use of biomarkers in clinical settings is expanding with the rise of anti-amyloid therapies. These new diagnostics and therapeutics require nuanced discussion of risks and benefits. Psychiatrist's skillset is uniquely suited for these complex evaluations.
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Affiliation(s)
- Amy Abramowitz
- UNC School of Medicine and UNC Hospitals, Chapel Hill, NC, USA.
| | - Michael Weber
- UNC School of Medicine and UNC Hospitals, Chapel Hill, NC, USA
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2
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Kraft JN, Indahlastari A, Boutzoukas EM, Hausman HK, Hardcastle C, Albizu A, O'Shea A, Evangelista ND, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, DeKosky ST, Hishaw GA, Wu S, Marsiske M, Cohen R, Alexander GE, Porges E, Woods AJ. The impact of a tDCS and cognitive training intervention on task-based functional connectivity. GeroScience 2024; 46:3325-3339. [PMID: 38265579 PMCID: PMC11009202 DOI: 10.1007/s11357-024-01077-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024] Open
Abstract
Declines in several cognitive domains, most notably processing speed, occur in non-pathological aging. Given the exponential growth of the older adult population, declines in cognition serve as a significant public health issue that must be addressed. Promising studies have shown that cognitive training in older adults, particularly using the useful field of view (UFOV) paradigm, can improve cognition with moderate to large effect sizes. Additionally, meta-analyses have found that transcranial direct current stimulation (tDCS), a non-invasive form of brain stimulation, can improve cognition in attention/processing speed and working memory. However, only a handful of studies have looked at concomitant tDCS and cognitive training, usually with short interventions and small sample sizes. The current study assessed the effect of a tDCS (active versus sham) and a 3-month cognitive training intervention on task-based functional connectivity during completion of the UFOV task in a large older adult sample (N = 153). We found significant increased functional connectivity between the left and right pars triangularis (the ROIs closest to the electrodes) following active, but not sham tDCS. Additionally, we see trending behavioral improvements associated with these functional connectivity changes in the active tDCS group, but not sham. Collectively, these findings suggest that tDCS and cognitive training can be an effective modulator of task-based functional connectivity above and beyond a cognitive training intervention alone.
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Affiliation(s)
- Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Emily J Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Steven T DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- McKnight Brain Institute and Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Tucson, AZ, USA
| | - Samuel Wu
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- McKnight Brain Institute and Department of Neurology, University of Florida, Gainesville, FL, USA
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Tucson, AZ, USA
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA.
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
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Jain U, Ma M. Together in sickness and in health: Spillover of physical, mental, and cognitive health among older English couples. HEALTH ECONOMICS 2024. [PMID: 38820139 DOI: 10.1002/hec.4860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 06/02/2024]
Abstract
Using data from eight waves of the English Longitudinal Study of Aging, we study the cross-domain and cross-spouse spillover of health among married adults aged 50 and above in England. We apply the system generalized method of moments to linear dynamic panel models for physical, mental, and cognitive health, controlling for individual heterogeneity and the influence of marriage market matching and shared environments. Our findings reveal bidirectional spillovers between memory abilities and mobility difficulty among men, as well as between depressive symptoms and mobility difficulty among women. Worsening mobility increases the risk of depression in men, but not vice versa. Additionally, gender-specific cross-spouse effects are observed. Women's mental health is significantly influenced by their spouse's mental health, while this effect is weaker for men. Conversely, men's mental health is notably affected by their spouse's physical health. These results highlight the importance of considering spillovers within families and across health domains when developing policies to promote health and reduce health disparities among the elderly population.
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Affiliation(s)
- Urvashi Jain
- Mitchell College of Business, University of South Alabama, Mobile, Alabama, USA
| | - Mingming Ma
- International Business School Suzhou, Xi'an Jiaotong-Liverpool University, Suzhou, China
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Varma P, Postnova S, Knock S, Howard ME, Aidman E, Rajaratnam SWM, Sletten TL. SleepSync: Early Testing of a Personalised Sleep-Wake Management Smartphone Application for Improving Sleep and Cognitive Fitness in Defence Shift Workers. Clocks Sleep 2024; 6:267-280. [PMID: 38920420 PMCID: PMC11203003 DOI: 10.3390/clockssleep6020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
Shift work, long work hours, and operational tasks contribute to sleep and circadian disruption in defence personnel, with profound impacts on cognition. To address this, a digital technology, the SleepSync app, was designed for use in defence. A pre-post design study was undertaken to examine whether four weeks app use improved sleep and cognitive fitness (high performance neurocognition) in a cohort of shift workers from the Royal Australian Air Force. In total, 13 of approximately 20 shift-working personnel from one base volunteered for the study. Sleep outcomes were assessed using the Insomnia Severity Index (ISI), the Patient-Reported Outcomes Measurement Information System (PROMIS), Sleep Disturbance and Sleep-Related Impairment Scales, the Glasgow Sleep Effort Scale, the Sleep Hygiene Index, and mental health was assessed using the Depression, Anxiety, and Stress Scale-21. Sustained attention was measured using the 3-min Psychomotor Vigilance Task (PVT) and controlled response using the NBack. Results showed significant improvements in insomnia (ISI scores 10.31 at baseline and 7.50 after app use), sleep-related impairments (SRI T-scores 53.03 at baseline to 46.75 post-app use), and healthy sleep practices (SHI scores 21.61 at baseline to 18.83 post-app use; all p < 0.001). Trends for improvement were recorded for depression. NBack incorrect responses reduced significantly (9.36 at baseline; reduced by -3.87 at last week of app use, p < 0.001), but no other objective measures improved. These findings suggest that SleepSync may improve sleep and positively enhance cognitive fitness but warrants further investigation in large samples. Randomised control trials with other cohorts of defence personnel are needed to confirm the utility of this intervention in defence settings.
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Affiliation(s)
- Prerna Varma
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Svetlana Postnova
- School of Physics, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Stuart Knock
- School of Physics, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Mark E. Howard
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3168, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Eugene Aidman
- Defence, Science and Technology Group, Department of Defence, Edinburgh, SA 5111, Australia;
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Shantha W. M. Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3168, Australia
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Tracey L. Sletten
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3168, Australia
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Hong J, Chu NM, Cockey SG, Long J, Cronin N, Ghildayal N, Hall RK, Huisingh-Scheetz M, Scherer J, Segev DL, McAdams-DeMarco MA. Frailty, but not cognitive impairment, improves mortality risk prediction among those with chronic kidney disease-a nationally representative study. BMC Nephrol 2024; 25:177. [PMID: 38778286 PMCID: PMC11112880 DOI: 10.1186/s12882-024-03613-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Though older adults with chronic kidney disease (CKD) have a greater mortality risk than those without CKD, traditional risk factors poorly predict mortality in this population. Therefore, we tested our hypothesis that two common geriatric risk factors, frailty and cognitive impairment, and their co-occurrence, might improve mortality risk prediction in CKD. METHODS Among participants aged ≥ 60 years from National Health and Nutrition Examination Survey (2011-2014), we quantified associations between frailty (physical frailty phenotype) and global/domain-specific cognitive function (immediate-recall [CERAD-WL], delayed-recall [CERAD-DL], verbal fluency [AF], executive function/processing speed [DSST], and global [standardized-average of 4 domain-specific tests]) using linear regression, and tested whether associations differed by CKD using a Wald test. We then tested whether frailty, global cognitive impairment (1.5SD below the mean), or their combination improved prediction of mortality (Cox models, c-statistics) compared to base models (likelihood-ratios) among those with and without CKD. RESULTS Among 3,211 participants, 1.4% were cognitively impaired, and 10.0% were frail; frailty and cognitive impairment co-occurrence was greater among those with CKD versus those without (1.2%vs.0.1%). Frailty was associated with worse global cognitive function (Cohen's d = -0.26SD,95%CI -0.36,-0.17), and worse cognitive function across all domains; these associations did not differ by CKD (pinteractions > 0.05). Mortality risk prediction improved only among those with CKD when accounting for frailty (p[likelihood ratio test] < 0.001) but not cognitive impairment. CONCLUSIONS Frailty is associated with worse cognitive function regardless of CKD status. While CKD and frailty improved mortality prediction, cognitive impairment did not. Risk prediction tools should incorporate frailty to improve mortality prediction among those with CKD.
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Affiliation(s)
- Jingyao Hong
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA
| | - Nadia M Chu
- Department of Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Samuel G Cockey
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA
| | - Jane Long
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA
| | - Nicolai Cronin
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA
| | - Nidhi Ghildayal
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA
| | - Rasheeda K Hall
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Megan Huisingh-Scheetz
- Department of Medicine, University of Chicago, Section of Geriatrics and Palliative Medicine, Chicago, IL, USA
| | - Jennifer Scherer
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Dorry L Segev
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA.
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
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Attarha M, Mahncke H, Merzenich M. The Real-World Usability, Feasibility, and Performance Distributions of Deploying a Digital Toolbox of Computerized Assessments to Remotely Evaluate Brain Health: Development and Usability Study. JMIR Form Res 2024; 8:e53623. [PMID: 38739916 PMCID: PMC11130778 DOI: 10.2196/53623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/15/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND An ongoing global challenge is managing brain health and understanding how performance changes across the lifespan. OBJECTIVE We developed and deployed a set of self-administrable, computerized assessments designed to measure key indexes of brain health across the visual and auditory sensory modalities. In this pilot study, we evaluated the usability, feasibility, and performance distributions of the assessments in a home-based, real-world setting without supervision. METHODS Potential participants were untrained users who self-registered on an existing brain training app called BrainHQ. Participants were contacted via a recruitment email and registered remotely to complete a demographics questionnaire and 29 unique assessments on their personal devices. We examined participant engagement, descriptive and psychometric properties of the assessments, associations between performance and self-reported demographic variables, cognitive profiles, and factor loadings. RESULTS Of the 365,782 potential participants contacted via a recruitment email, 414 (0.11%) registered, of whom 367 (88.6%) completed at least one assessment and 104 (25.1%) completed all 29 assessments. Registered participants were, on average, aged 63.6 (SD 14.8; range 13-107) years, mostly female (265/414, 64%), educated (329/414, 79.5% with a degree), and White (349/414, 84.3% White and 48/414, 11.6% people of color). A total of 72% (21/29) of the assessments showed no ceiling or floor effects or had easily modifiable score bounds to eliminate these effects. When correlating performance with self-reported demographic variables, 72% (21/29) of the assessments were sensitive to age, 72% (21/29) of the assessments were insensitive to gender, 93% (27/29) of the assessments were insensitive to race and ethnicity, and 93% (27/29) of the assessments were insensitive to education-based differences. Assessments were brief, with a mean duration of 3 (SD 1.0) minutes per task. The pattern of performance across the assessments revealed distinctive cognitive profiles and loaded onto 4 independent factors. CONCLUSIONS The assessments were both usable and feasible and warrant a full normative study. A digital toolbox of scalable and self-administrable assessments that can evaluate brain health at a glance (and longitudinally) may lead to novel future applications across clinical trials, diagnostics, and performance optimization.
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Ben Izhak S, Diedrich L, Antal A, Lavidor M. Beyond social engagement: cognitive training leads to greater cognitive improvement in older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:556-574. [PMID: 37221447 DOI: 10.1080/13825585.2023.2216927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023]
Abstract
Aging is often accompanied by a decline in cognitive functions, with memory being particularly affected. Recent studies suggest that cognitive training sessions that teach memory strategies relevant to daily life may benefit seniors who live in the community. However, it is possible that the cognitive improvement observed in these programs results from the social encounters embedded in them. In this study, we aimed to investigate the effect of a social cognitive training group, which met regularly for an extended period, on enhancing cognitive indices compared to a control group that only received social engagement meetings without training. Sixty-six participants with a mean age of 78 took part in 12 sessions of a social engagement group, with or without strategy training. Cognitive performance was assessed before and after training using four memory tasks, two similar to the trained tasks (near-transfer tasks) and two novel (far-transfer tasks). Both groups showed a slight improvement in most of the evaluation tasks, but the cognitive training combined with social engagement group showed a significant improvement in the Word Recall and Verbal Fluency tests compared to the social engagement group without training. Our findings suggest that cognitive training sessions may be a useful tool in promoting cognitive improvement among older adults living in the community, even beyond the improvement obtained from the social engagement that occurs during the training sessions.Trial registration number:NCT05016336. Date of registration: 20 August 2021. Retrospectively registered.
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Affiliation(s)
- Shachar Ben Izhak
- Department of Psychology, and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Lukas Diedrich
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Michal Lavidor
- Department of Psychology, and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
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Corbett A, Williams G, Creese B, Hampshire A, Palmer A, Brooker H, Ballard C. Impact of Short-Term Computerized Cognitive Training on Cognition in Older Adults With and Without Genetic Risk of Alzheimer's Disease: Outcomes From the START Randomized Controlled Trial. J Am Med Dir Assoc 2024; 25:860-865. [PMID: 38642588 DOI: 10.1016/j.jamda.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES To establish the impact of a 3-minute computerized cognitive training program (START) on cognition in older adults with and without genetic risk of Alzheimer's disease. DESIGN Two-arm randomized controlled trial of the START program. SETTING AND PARTICIPANTS Remote online trial in adults older than 50 taking part from home. METHODS The trial compared the START program with placebo in 6544 people older than 50. Primary outcome was executive function measured through Trailmaking B, with other secondary cognitive measures. Genetic risk profile and ApoE4 status were determined by Illumina Array. RESULTS START conferred benefit to executive function, attention, memory, and a composite measure, including in people with the ApoE4 genotype. CONCLUSIONS AND IMPLICATIONS The 3-minute START task offers a means of supporting cognitive health in older adults and could be used at scale and within a precision medicine approach to reduce risk of cognitive decline in a targeted way.
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Affiliation(s)
- Anne Corbett
- Department of Health and Community Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK.
| | - Gareth Williams
- Wolfson Centre for Age-Related Diseases, King's College London, London, UK
| | - Byron Creese
- Division of Psychology, Department of Life Sciences, Brunel University, London, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London UK
| | - Adam Hampshire
- Division of Psychology, Department of Life Sciences, Brunel University, London, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London UK
| | - Abbie Palmer
- Department of Health and Community Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Clive Ballard
- Department of Clinical Biosciences, University of Exeter Medical School, University of Exeter, Exeter, UK
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Pazoki Z, Kheirkhah MT, Gharibzadeh S. Cognitive training interventions for substance use disorders: what they really offer? Front Public Health 2024; 12:1388935. [PMID: 38694981 PMCID: PMC11061450 DOI: 10.3389/fpubh.2024.1388935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/04/2024] [Indexed: 05/04/2024] Open
Abstract
Cognitive training (CT) has emerged as a potential therapeutic approach for substance use disorders (SUD), aiming to restore cognitive impairments and potentially improve treatment outcomes. However, despite promising findings, the effectiveness of CT in real-life applications and its impact on SUD symptoms has remained unclear. This perspective article critically examines the existing evidence on CT for SUD and explores the challenges and gaps in implementing CT interventions. It emphasizes the need for clarity in expectations and decision-making from a public health standpoint, advocating for comprehensive studies that consider a broader range of SUD consequences and utilize measures that reflect patients' actual experiences.
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Affiliation(s)
- Zahra Pazoki
- School of Behavioral Sciences and Mental Health, Iran University of Medical Science, Tehran, Iran
| | | | - Shahriar Gharibzadeh
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
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10
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Watanabe M, Cartwright J, Pierce JE. Positive effects of speech and language therapy group interventions in primary progressive aphasia: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024. [PMID: 38602276 DOI: 10.1111/1460-6984.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/08/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Primary progressive aphasia (PPA) is a neurodegenerative condition characterised by a prominent and progressive deterioration in language abilities, which significantly impacts quality of life and interpersonal relationships. Speech and language therapy plays a crucial role in offering interventions. Group intervention is one mode of delivery that could benefit communication functioning and overall wellbeing of people with PPA (pwPPA) and their care partners. Group interventions are also more efficient than one-to-one intervention and may facilitate peer support. AIMS The aim of this review was to systematically evaluate the current evidence for the effectiveness of speech and language therapy groups for pwPPA and their care partners. Specifically, this paper considered three questions: 1.What evidence-based speech and language therapy groups for pwPPA and their care partners have been reported to date? 2.Are group communication interventions effective in improving quality of life and communication function for pwPPA and their care partners? 3.Are group communication interventions that are designed for people with communication difficulties of other aetiologies (such as stroke) effective for pwPPA? In addition, this review aimed to describe the structure and content of groups, including aims, disciplines involved, size and frequency of group meetings, and outcome measures. METHODS MEDLINE, CINAHL and PsycINFO were used to retrieve articles of interest. A total of 10 studies published between 2009 and 2022 met the eligibility criteria and therefore were included in this study. Data were extracted from the articles regarding the structure and content of groups. MAIN CONTRIBUTION Although evidence is currently limited, results suggest that speech and language therapy group intervention can improve specific linguistic processes, the use of communication strategies and psychosocial well-being. The importance of multidisciplinary input and care partners' involvement in groups was highlighted, along with the benefits of creative non-verbal activities as tools for self-expression. There is also initial evidence that telehealth group provision and one-off group sessions may be feasible and can benefit psychosocial well-being. Lastly, intentional recruitment and explicit education on different aphasia types are described as important when pwPPA participate in groups with mixed diagnoses. CONCLUSIONS The literature on speech and language therapy group interventions for PPA shows promise of positive effects on communication function and psychosocial well-being of both pwPPA and their care partners. Speech and language therapists can consider these published interventions when designing and implementing similar groups, but more robust evidence is required to confirm the relative effectiveness of this approach. WHAT THIS PAPER ADDS What is already known on this subject Speech pathology led group intervention shows some promise in benefitting communication functioning and overall well-being of pwPPA and their carers, but there has been no systematic evaluation of all the evidence regarding the efficacy of speech and language therapy led groups. Establishing feasibility, acceptability and efficacy of speech and language therapy group interventions for pwPPA and their carers may present a valuable addition for managing this progressive language disability. What this paper adds to existing knowledge Although evidence is currently limited, results from this systematic review suggest that speech and language therapy led group intervention can improve specific linguistic processes, the use of communication strategies and psychosocial well-being for pwPPA and their carers. The importance of multidisciplinary input and carers' involvement in groups was highlighted, along with the benefits of creative non-verbal activities as tools for self-expression. There is also initial evidence that telehealth group provision for carers may be feasible and can benefit psychosocial wellbeing. Lastly, intentional recruitment and explicit education on different aphasia types are described as important when pwPPA participate in groups with mixed diagnoses. What are the potential or actual clinical implications of this work? A synthesis of the evidence base for speech and language therapy led PPA groups, as well as a description of the group components and formats, will be valuable for clinical service planning, and will guide future examination of group options for pwPPA and their carers. Speech and language therapists can also consider the research findings from this systematic review when designing and implementing similar groups in their local context.
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Affiliation(s)
| | - Jade Cartwright
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - John E Pierce
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Speech Pathology, La Trobe University, Melbourne, Victoria, Australia
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Dowell-Esquivel C, Czaja SJ, Kallestrup P, Depp CA, Saber JN, Harvey PD. Computerized Cognitive and Skills Training in Older People With Mild Cognitive Impairment: Using Ecological Momentary Assessment to Index Treatment-Related Changes in Real-World Performance of Technology-Dependent Functional Tasks. Am J Geriatr Psychiatry 2024; 32:446-459. [PMID: 37953132 PMCID: PMC10950539 DOI: 10.1016/j.jagp.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Cognitive and functional skills training improves skills and cognitive test performance, but the true test of efficacy is real-world transfer. We trained participants with mild cognitive impairment (MCI) or normal cognition (NC) for up to 12 weeks on six technology-related skills using remote computerized functional skills assessment and training (FUNSAT) software. Using ecological momentary assessment (EMA), we measured real-world performance of the technology-related skills over 6 months and related EMA-identified changes in performance to training gains. DESIGN Randomized clinical trial with post-training follow-up. SETTING A total of 14 Community centers in New York City and Miami. PARTICIPANTS Older adults with normal cognition (n = 72) or well-defined MCI (n = 92), ranging in age from 60 to 90, primarily female, and racially and ethnically diverse. INTERVENTION Computerized cognitive and skills training. MEASUREMENTS EMA surveys measuring trained and untrained functional skills 3 or more days per week for 6 months and training gains from baseline to end of training. RESULTS Training gains in completion times across all 6 tasks were significant (p <0.001) for both samples, with effect sizes more than 1.0 SD for all tasks. EMA surveys detected increases in performance for both trained (p <0.03) and untrained (p <0.001) technology-related skills for both samples. Training gains in completion times predicted increases in performance of both trained and untrained technology-related skills (all p <0.001). CONCLUSIONS Computerized training produces increases in real-world performance of important technology-related skills. These gains continued after the end of training, with greater gains in MCI participants.
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Affiliation(s)
| | - Sara J Czaja
- Weil Cornell School of Medicine (SJC), New York, NY; i-Function, Inc. (SJC, PK, PDH) Miami, FL
| | | | | | | | - Philip D Harvey
- University of Miami Miller School of Medicine (CDE, PDH), Miami, FL; i-Function, Inc. (SJC, PK, PDH) Miami, FL.
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12
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Jiang Y, Xie Y, Fang P, Shang Z, Chen L, Zhou J, Yang C, Zhu W, Hao X, Ding J, Yin P, Wang Z, Cao M, Zhang Y, Tan Q, Cheng D, Kong S, Lu X, Liu X, Sessler DI. Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e247361. [PMID: 38652478 PMCID: PMC11040409 DOI: 10.1001/jamanetworkopen.2024.7361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/20/2024] [Indexed: 04/25/2024] Open
Abstract
IMPORTANCE Postoperative delirium is a common and impactful neuropsychiatric complication in patients undergoing coronary artery bypass grafting surgery. Cognitive training may enhance cognitive reserve, thereby reducing postoperative delirium. OBJECTIVE To determine whether preoperative cognitive training reduces the incidence of delirium in patients undergoing coronary artery bypass grafting. DESIGN, SETTING, and PARTICIPANTS This prospective, single-blind, randomized clinical trial was conducted at 3 university teaching hospitals in southeastern China with enrollment between April 2022 and May 2023. Eligible participants included those scheduled for elective coronary artery bypass grafting who consented and enrolled at least 10 days before surgery. INTERVENTIONS Participating patients were randomly assigned 1:1, stratified by site, to either routine care or cognitive training, which included substantial practice with online tasks designed to enhance cognitive functions including memory, imagination, reasoning, reaction time, attention, and processing speed. MAIN OUTCOMES AND MEASURES The primary outcome was occurrence of delirium during postoperative days 1 to 7 or until hospital discharge, diagnosed using the Confusion Assessment Method or the Confusion Assessment Method for Intensive Care Units. Secondary outcomes were postoperative cognitive dysfunction, delirium characteristics, and all-cause mortality within 30 days following the operation. RESULTS A total of 218 patients were randomized and 208 (median [IQR] age, 66 [58-70] years; 64 female [30.8%] and 144 male [69.2%]) were included in final analysis, with 102 randomized to cognitive training and 106 randomized to routine care. Of all participants, 95 (45.7%) had only a primary school education and 54 (26.0%) had finished high school. In the cognitive training group, 28 participants (27.5%) developed delirium compared with 46 participants (43.4%) randomized to routine care. Those receiving cognitive training were 57% less likely to develop delirium compared with those receiving routine care (adjusted odds ratio [aOR] 0.43; 95% CI, 0.23-0.77; P = .007). Significant differences were observed in the incidence of severe delirium (aOR, 0.46; 95% CI, 0.25-0.82; P = .01), median (IQR) duration of delirium (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .008), and median (IQR) number of delirium-positive days (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .007). No other secondary outcomes differed significantly. CONCLUSIONS AND RELEVANCE In this randomized trial of 208 patients undergoing coronary artery bypass grafting, preoperative cognitive training reduced the incidence of postoperative delirium. However, our primary analysis was based on fewer than 75 events and should therefore be considered exploratory and a basis for future larger trials. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR2200058243.
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Affiliation(s)
- Yu Jiang
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Yanhu Xie
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Panpan Fang
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Zixiang Shang
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Lihai Chen
- Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jifang Zhou
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Chao Yang
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Wenjie Zhu
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Xixi Hao
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Jianming Ding
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Panpan Yin
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Zan Wang
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Mengyuan Cao
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Yu Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Qilian Tan
- Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Dan Cheng
- Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Siyu Kong
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Xianfu Lu
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Xuesheng Liu
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical, University, Hefei, Anhui, China
| | - Daniel I. Sessler
- Outcomes Research Consortium, Department of Anesthesiology, Cleveland Clinic, Cleveland, Ohio
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Schmitter-Edgecombe M, Luna C, Dai S, Cook DJ. Predicting daily cognition and lifestyle behaviors for older adults using smart home data and ecological momentary assessment. Clin Neuropsychol 2024:1-25. [PMID: 38503715 DOI: 10.1080/13854046.2024.2330143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE Extraction of digital markers from passive sensors placed in homes is a promising method for understanding real-world behaviors. In this study, machine learning (ML) and multilevel modeling (MLM) are used to examine types of digital markers and whether smart home sensors can predict cognitive functioning, lifestyle behaviors, and contextual factors measured through ecological momentary assessment (EMA). METHOD Smart home sensors were installed in the homes of 44 community-dwelling midlife and older adults for 3-4 months. Sensor data were categorized into eight digital markers. Participants responded to iPad-delivered EMA prompts 4×/day for 2 wk. Prompts included an n-back task and survey on recent (past 2 h) lifestyle and contextual factors. RESULTS ML marker rankings revealed that sensor counts (indicating increased activity) and time outside the home were among the most influential markers for all survey questions. Additionally, MLM revealed for every 1000 sensor counts, mental sharpness, social, physical, and cognitive EMA responses increased by 0.134-0.155 points on a 5-point scale. For every additional 30-minutes spent outside home, social, physical, and cognitive EMA responses increased by 0.596, 0.472, and 0.157 points. Advanced ML joint classification/regression significantly predicted EMA responses from smart home digital markers with error of 0.370 on a 5-point scale, and n-back performance with a normalized error of 0.040. CONCLUSION Results from ML and MLM were complimentary and comparable, suggesting that machine learning may be used to develop generalized models to predict everyday cognition and track lifestyle behaviors and contextual factors that impact health outcomes using smart home sensor data.
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Affiliation(s)
| | - Catherine Luna
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Shenghai Dai
- College of Education, Washington State University, Pullman, WA, USA
| | - Diane J Cook
- School of Electrical Engineering and Computer Science, Washington State University, Pullman, WA, USA
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14
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Li D, Zhou L, Cao Z, Wang J, Yang H, Lyu M, Zhang Y, Yang R, Wang J, Bian Y, Xu W, Wang Y. Associations of environmental factors with neurodegeneration: An exposome-wide Mendelian randomization investigation. Ageing Res Rev 2024; 95:102254. [PMID: 38430933 DOI: 10.1016/j.arr.2024.102254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Neurodegenerative diseases (NDDs) remain a global health challenge. Previous studies have reported potential links between environmental factors and NDDs, however, findings remain controversial across studies and elusive to be interpreted as evidence of robust causal associations. In this study, we comprehensively explored the causal associations of the common environmental factors with major NDDs including Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS), based on updated large-scale genome-wide association study data through two-sample Mendelian randomization (MR) approach. Our results indicated that, overall, 28 significant sets of exposure-outcome causal association evidence were detected, 12 of which were previously underestimated and newly identified, including average weekly beer plus cider intake, strenuous sports or other exercises, diastolic blood pressure, and body fat percentage with AD, alcohol intake frequency with PD, apolipoprotein B, systolic blood pressure, and forced expiratory volume in 1 s (FEV1) with ALS, and alcohol intake frequency, hip circumference, forced vital capacity, and FEV1 with MS. Moreover, the causal effects of several environmental factors on NDDs were found to overlap. From a triangulation perspective, our investigation provided insights into understanding the associations of environmental factors with NDDs, providing causality-oriented evidence to establish the risk profile of NDDs.
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Affiliation(s)
- Dun Li
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Lihui Zhou
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Zhi Cao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jida Wang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Hongxi Yang
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Mingqian Lyu
- Department of Computer Science, RWTH Aachen University, Aachen, 52062, Germany
| | - Yuan Zhang
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Rongrong Yang
- Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Ju Wang
- School of Biomedical Engineering, Tianjin Medical University, Tianjin 300070, China
| | - Yuhong Bian
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Health Care Sciences and Society Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden
| | - Yaogang Wang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; School of Public Health, Tianjin Medical University, Tianjin 300070, China; Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; National Institute of Health Data Science at Peking University, Peking University, Beijing 100191, China.
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15
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Bollimbala A, James PS. Impact of chronic physical activity on individuals' creativity. PSYCHOLOGICAL RESEARCH 2024; 88:684-694. [PMID: 37561201 DOI: 10.1007/s00426-023-01862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
There is growing evidence to suggest that physical activity positively influences cognitive processes. A similar trend is seen in the literature examining the relationship between acute physical activity and creativity. Nevertheless, certain questions persist: Does engaging in physical activity over an extended period (chronic) influence creativity? If it does, what is the duration of this impact? The present study uses Randomized Controlled Trials (RCT) to examine whether chronic physical activity for 6 weeks can improve individual creativity vis-à-vis a control group that performs regular class activity without any physical activity. It also assesses whether the effect of chronic physical activity on creativity endures after 2 weeks of ceasing the interventions. The study involves 49 school students who were randomly assigned to either the experimental or the control conditions. Their creativity, operationalized as divergent thinking is measured using the Alternate Uses Task. The measurements are taken before the intervention, again 6 weeks later, and once more, after 2 weeks of cessation of interventions. The results indicate that after 6 weeks of engaging in physical activity, the participants showed improvements in both the fluency and originality components of divergent thinking when compared to the control group. Furthermore, the results demonstrate a lingering effect of physical activity on the originality component of divergent thinking. The findings lend some support to the strength model of self-control. The implications for research and practice are further discussed in the study.
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Affiliation(s)
- Ashish Bollimbala
- School of Management, Indian Institute of Technology Mandi, Kamand, Himachal Pradesh, 175005, India.
| | - P S James
- School of Management, DC School of Management and Technology, Vagamon, Kerala, India
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16
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Madeira ES, Souza PAD, Amaral A. Remote activities of cognitive stimulation for older adults during the COVID-19 pandemic: a systematic review. CAD SAUDE PUBLICA 2024; 40:e00081923. [PMID: 38422247 PMCID: PMC10896484 DOI: 10.1590/0102-311xen081923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 03/02/2024] Open
Abstract
Cognitive stimulation activities for older adults are generally carried out in face-to-face workshops. However, during the COVID-19 pandemic, these activities and consultations became remote due to social isolation, enabling care to continue safely. This study aims to analyze the remote cognitive stimulation and/or telerehabilitation activities for older people that were carried out as an intervention during the COVID-19 pandemic. This is a systematic review study with five selected articles, conducted according to the PRISMA statement methodology. Among the main results, the feasibility and acceptance of remote cognitive stimulation activities using technologies during the pandemic stand out, reflecting on future and expanded use for different realities and cultures. the studies reviewed also indicate the stabilization and improvement of the cognitive state and of depressive and anxious feelings, as well as the maintenance of independence of these participants, with an increase in scores on scales applied before and after the interventions. In conclusion, the activities carried out in cognitive stimulation and/or telerehabilitation therapies for older adults as an intervention during the COVID-19 pandemic had an average of 47 participants; the technologies used for the activities were tablet and personal computer; pre-installed programs were the most used strategy; and the interventions lasted from 1 to 3 months, with activities 2 to 3 times per week. The reinvention of techniques aimed at stimulating and rehabilitating the cognitive health of the older adults, via technologies as a strategy to replace or complement face-to-face activities, promotes the cognitive and mental health and independence of the older population.
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Affiliation(s)
- Etiene Souza Madeira
- Programa de Pós-graduação em Enfermagem, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Anderson Amaral
- Programa de Pós-graduação em Enfermagem, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Lee PL, Huang CK, Chen YY, Chang HH, Cheng CH, Lin YC, Lin CL. Enhancing Cognitive Function in Older Adults through Processing Speed Training: Implications for Cognitive Health Awareness. Healthcare (Basel) 2024; 12:532. [PMID: 38470642 PMCID: PMC10930606 DOI: 10.3390/healthcare12050532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/31/2024] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
It may be possible to enhance adults' cognitive health and promote healthy aging through processing speed training using the Useful Field of View (UFOV) related activities and software. This study investigated the impact of utilizing UFOV on processing speed improvement in older adults in response to the growing global attention on cognitive health and aging issues. In this quasi-experimental study, 22 individuals (mean age ± SD = 71.9 ± 4.8) participated in the experimental group, and 20 community-based participants (mean age ± SD = 67.1 ± 4.8) were in the control group. The intervention involved ten sessions of UFOV training, each lasting 60 min, conducted twice a week for the experimental group while the control group engaged in volunteer service activities. Measurements of Counting Back, Fabrica, Double-Decision, and Hawkeye were administered to all participants before and after the intervention. The results showed significant improvements in the experimental group for the four measurements (p ≤ 0.01, 0.05, 0.001, 0.001) and non-significant gains in the control group (p ≥ 0.05) for all. Furthermore, mixed repeated-measures ANOVA analysis, with time 1 pre-test measures as the covariate, revealed significant interaction effects between time and group for all measurement indicators (p = 0.05, 0.01, 0.05) except for Fabrica (p > 0.05). In conclusion, these findings support the effectiveness of UFOV cognitive training interventions in enhancing specific cognitive abilities.
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Affiliation(s)
- Pai-Lin Lee
- Graduate School of Adult Education, National Kaohsiung Normal University, Kaohsiung 80201, Taiwan
| | - Chih-Kun Huang
- Department of Social Work, National Quemoy University, Kinmen 892009, Taiwan;
| | - Yi-Yi Chen
- Wenzao Chinese Language Center, Wenzao Ursuline University of Languages, Kaohsiung 807679, Taiwan;
| | - Hui-Hsiang Chang
- Center for English Language Teaching, Wenzao Ursuline University of Languages, Kaohsiung 807679, Taiwan;
| | - Chun-Hua Cheng
- Occupational Therapy Department, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 802511, Taiwan;
| | - Yu-Chih Lin
- Division of General Internal Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807377, Taiwan;
| | - Chia-Li Lin
- Department of International Business, Ming Chuan University, Taipei 111, Taiwan;
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Harvey PD, Dowell-Esquivel C, Macchiarelli JE, Martinez A, Kallestrup P, Czaja SJ. Early prediction of mastery of a computerized functional skills training program in participants with mild cognitive impairment. Int Psychogeriatr 2024:1-12. [PMID: 38380470 DOI: 10.1017/s1041610224000115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Cognition in MCI has responded poorly to pharmacological interventions, leading to use of computerized training. Combining computerized cognitive training (CCT) and functional skills training software (FUNSAT) produced improvements in 6 functional skills in MCI, with effect sizes >0.75. However, 4% of HC and 35% of MCI participants failed to master all 6 tasks. We address early identification of characteristics that identify participants who do not graduate, to improve later interventions. METHODS NC participants (n = 72) received FUNSAT and MCI (n = 92) participants received FUNSAT alone or combined FUNSAT and CCT on a fully remote basis. Participants trained twice a week for up to 12 weeks. Participants "graduated" each task when they made one or fewer errors on all 3-6 subtasks per task. Tasks were no longer trained after graduation. RESULTS Between-group comparisons of graduation status on baseline completion time and errors found that failure to graduate was associated with more baseline errors on all tasks but no longer completion times. A discriminant analysis found that errors on the first task (Ticket purchase) uniquely separated the groups, F = 41.40, p < .001, correctly classifying 94% of graduators. An ROC analysis found an AUC of .83. MOCA scores did not increase classification accuracy. CONCLUSIONS More baseline errors, but not completion times, predicted failure to master all FUNSAT tasks. Accuracy of identification of eventual mastery was exceptional. Detection of risk to fail to master training tasks is possible in the first 15 minutes of the baseline assessment. This information can guide future enhancements of computerized training.
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Affiliation(s)
- Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, USA
- I-Function, Inc, Miami, FL, USA
| | | | | | | | | | - Sara J Czaja
- I-Function, Inc, Miami, FL, USA
- Weill-Cornell Medical Center, New York, NY, USA
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Wang H, Pei Z, Liu Y. Effects of square dance exercise on cognitive function in elderly individuals with mild cognitive impairment: the mediating role of balance ability and executive function. BMC Geriatr 2024; 24:156. [PMID: 38360628 PMCID: PMC10870555 DOI: 10.1186/s12877-024-04714-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Square dancing is a kind of aerobic fitness exercise without environmental restrictions that yields many benefits for physical and mental health; this exercise is popular among middle-aged and elderly people in China and in these populations in other countries. This study aimed to evaluate the effects of square dance exercise on the overall cognitive function of elderly individuals with mild cognitive impairment (MCI) and to research its mechanisms. METHODS A total of 60 elderly people with MCI (60-69 years old) without square dance experience were selected and randomly divided into an experimental group (n = 30) and a control group (n = 30). The experimental group participated in square dance exercise for 12 weeks, while the control group maintained their original lifestyle habits. One week before and after the intervention period, the overall cognitive function, physical fitness, and executive function of both groups were measured. RESULTS According to the results, square dance exercise directly improved the overall cognitive function of elderly individuals with MCI and indirectly affected overall cognitive function through the mediating effects of balance ability and executive function. CONCLUSIONS Square dance exercise represents a nonpharmacological intervention for the prevention and treatment of MCI. Importantly, it is best to combine this exercise with other forms of physical exercise and comprehensive treatment programs such as cognitive training, social interaction, and psychological intervention to realize its maximum effect.
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Affiliation(s)
- Heng Wang
- College of Physical Education, Henan Normal University, 453007, Xinxiang, China.
| | - Zhengguo Pei
- College of Physical Education, Henan Normal University, 453007, Xinxiang, China
| | - Yangyang Liu
- College of Physical Education, Henan Normal University, 453007, Xinxiang, China
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Kang K, Antonenko D, Glöckner F, Flöel A, Li SC. Neural correlates of home-based intervention effects on value-based sequential decision-making in healthy older adults. AGING BRAIN 2024; 5:100109. [PMID: 38380149 PMCID: PMC10876581 DOI: 10.1016/j.nbas.2024.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
Older adults demonstrate difficulties in sequential decision-making, which is partly attributed to under-recruitment of prefrontal networks. It is, therefore, important to understand the mechanisms that may improve this ability. This study investigated the effectiveness of an 18-sessions, home-based cognitive intervention and the neural mechanisms that underpin individual differences in intervention effects. Participants were required to learn sequential choices in a 3-stage Markov decision-making task that would yield the most rewards. Participants were assigned to better or worse responders group based on their performance at the last intervention session (T18). Better responders improved significantly starting from the fifth intervention session while worse responders did not improve across all training sessions. At post-intervention, only better responders showed condition-dependent modulation of the dorsolateral prefrontal cortex (DLPFC) as measured by fNIRS, with higher DLPFC activity in the delayed condition. Despite large individual differences, our data showed that value-based sequential-decision-making and its corresponding neural mechanisms can be remediated via home-based cognitive intervention in some older adults; moreover, individual differences in recruiting prefrontal activities after the intervention are associated with variations in intervention outcomes. Intervention-related gains were also maintained at three months after post-intervention. However, future studies should investigate the potential of combining other intervention methods such as non-invasive brain stimulation with cognitive intervention for older adults who do not respond to the intervention, thus emphasizing the importance of developing individualized intervention programs for older adults.
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Affiliation(s)
- Kathleen Kang
- Chair of Lifespan Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Daria Antonenko
- Department of Neurology, University Medicine of Greifswald, Greifswald, Germany
| | - Franka Glöckner
- Chair of Lifespan Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine of Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, Greifswald, Germany
| | - Shu-Chen Li
- Chair of Lifespan Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop, Technische Universität Dresden, Dresden, Germany
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Veneziano M, Piazza MF, Palummeri E, Paganino C, Andreoli GB, Amicizia D, Ansaldi F. A Longitudinal Study on Cognitive Training for Cognitively Preserved Adults in Liguria, Italy. Healthcare (Basel) 2024; 12:393. [PMID: 38338278 PMCID: PMC10855271 DOI: 10.3390/healthcare12030393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/13/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
In this study, we examined the effects of memory training on cognitive function and depressive symptoms in a cohort of 794 healthy adults aged 50 years or older. Participants were divided into an active intervention group and a passive intervention group, with various cognitive measures assessed over a one-year period. Univariate analysis revealed that the active intervention group consistently outperformed the passive group in measures of memory self-perception (Memory Complaint Questionnaire-MACQ), depressive symptoms (Geriatric Depression Scale-GDS-4), verbal memory and recall ability (A3LP), and verbal fluency (VF). Significant differences in MACQ scores were observed between the two groups at all time points, indicating enhanced memory self-perception in the active group. GDS-4 scores consistently favored the active group, suggesting a reduction in depressive symptoms. A3LP scores demonstrated that the active group had better verbal memory and recall abilities. VF scores consistently favored the active group, indicating superior language skills and cognitive flexibility. Linear regression model and mixed linear regression model reinforced these findings, with highly significant interaction effects observed between the active/passive group, gender, age, education, and time. These effects were particularly pronounced for MACQ and A3LP scores, indicating the combined impact of these factors on memory self-perception and verbal memory. This study highlights the positive impact of memory training intervention on cognitive function and depressive symptoms in older adults and underscores the importance of considering gender, age, and education in cognitive interventions. Notably, these benefits persist for up to six months from the end of the program. The results provide valuable insights into cognitive changes in aging populations and suggest that tailored memory training programs can yield significant improvements.
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Affiliation(s)
| | - Maria Francesca Piazza
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
| | - Ernesto Palummeri
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
| | - Chiara Paganino
- Local Health Unit 3 (ASL3), 16125 Genoa, Italy; (M.V.); (C.P.)
| | | | - Daniela Amicizia
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
| | - Filippo Ansaldi
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (E.P.); (G.B.A.); or (D.A.); or (F.A.)
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy
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22
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Chen H, Ye KX, Feng Q, Cao K, Yu J, Li C, Zhang C, Yu L, Maier AB, Langa KM, Qiu C, Zeng Y, Feng L. Trends in the prevalence of cognitive impairment at old age in China, 2002-2018. Alzheimers Dement 2024; 20:1387-1396. [PMID: 38009699 PMCID: PMC10917034 DOI: 10.1002/alz.13545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/06/2023] [Accepted: 10/14/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION China has the world's largest number of older adults with cognitive impairment (CI). We aimed to examine secular trends in the prevalence of CI in China from 2002 to 2018. METHODS Generalized estimating equations (GEE) was used to assess changes in CI trend in 44,154 individuals (72,027 observations) aged 65 to 105 years old. RESULTS The prevalence of CI increased from 2002 to 2008 and then decreased until 2018. The age-standardized prevalence increased from 25.7% in 2002, 26.1% in 2005, to 28.2% in 2008, then decreased to 26.0% in 2011, 25.3% in 2014, and 24.9% in 2018. Females and those ≥ 80 years old had greater CI prevalence. DISCUSSION The prevalence of CI showed an inverted U shape from early 2000s to late 2010s with a peak in 2008. Follow-up studies are needed to confirm the decreasing trend after 2008 and examine the contributing factors and underlying mechanisms of this trend. HIGHLIGHTS Generalized estimating equations (GEE) were used to assess trends of changes in cognitive impairment (CI). CI prevalence in China increased from 2002 to 2008 and then decreased until 2018. Females and those ≥ 80 years old had greater CI prevalence. Stroke, diabetes, and cigarette smoking were risk factors for CI.
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Affiliation(s)
| | - Kaisy Xinhong Ye
- Department of Psychological MedicineYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
- Centre for Healthy Longevity, @AgeSingapore, National University Health SystemSingaporeSingapore
| | - Qiushi Feng
- Department of Sociology and AnthropologyFaculty of Arts and Social SciencesNational University of SingaporeSingaporeSingapore
| | - Kai Cao
- Key Laboratory of Geographic Information Science (Ministry of Education) and School of Geographic Sciences, East China Normal UniversityShanghaiChina
| | - Jintai Yu
- Huashan HospitalFudan UniversityShanghaiChina
| | - Chunbo Li
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Institute of Psychology and Behavioural Science, Shanghai Jiao Tong UniversityShanghaiChina
| | - Can Zhang
- Department of NeurologyGenetics and Aging Research Unit, McCance Centre for Brain Health, Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Lirong Yu
- School of NursingWeifang Medical UniversityWeifangChina
| | - Andrea Britta Maier
- Key Laboratory of Geographic Information Science (Ministry of Education) and School of Geographic Sciences, East China Normal UniversityShanghaiChina
- Department of Human Movement Sciences, @AgeAmsterdamVrije Universiteit Amsterdam, Amsterdam Movement SciencesAmsterdamthe Netherlands
- Department of Medicine and Aged Care, @AgeMelbourneThe Royal Melbourne HospitalThe University of MelbourneParkvilleVictoriaAustralia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Kenneth M. Langa
- Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Chengxuan Qiu
- Aging Research CentreDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
| | - Yi Zeng
- Centre for Healthy Aging and Development StudiesNational School of DevelopmentPeking UniversityBeijingChina
- Centre for the Study of Aging and Human Development and Geriatrics DivisionSchool of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Lei Feng
- Department of Psychological MedicineYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
- Centre for Healthy Longevity, @AgeSingapore, National University Health SystemSingaporeSingapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
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Baker LD, Snyder HM, Espeland MA, Whitmer RA, Kivipelto M, Woolard N, Katula J, Papp KV, Ventrelle J, Graef S, Hill MA, Rushing S, Spell J, Lovato L, Felton D, Williams BJ, Ghadimi Nouran M, Raman R, Ngandu T, Solomon A, Wilmoth S, Cleveland ML, Williamson JD, Lambert KL, Tomaszewski Farias S, Day CE, Tangney CC, Gitelman DR, Matongo O, Reynolds T, Pavlik VN, Yu MM, Alexander AS, Elbein R, McDonald AM, Salloway S, Wing RR, Antkowiak S, Morris MC, Carrillo MC. Study design and methods: U.S. study to protect brain health through lifestyle intervention to reduce risk (U.S. POINTER). Alzheimers Dement 2024; 20:769-782. [PMID: 37776210 PMCID: PMC10916955 DOI: 10.1002/alz.13365] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 10/02/2023]
Abstract
INTRODUCTION The U.S. study to protect brain health through lifestyle intervention to reduce risk (U.S. POINTER) is conducted to confirm and expand the results of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) in Americans. METHODS U.S. POINTER was planned as a 2-year randomized controlled trial of two lifestyle interventions in 2000 older adults at risk for dementia due to well-established factors. The primary outcome is a global cognition composite that permits harmonization with FINGER. RESULTS U.S. POINTER is centrally coordinated and conducted at five clinical sites (ClinicalTrials.gov: NCT03688126). Outcomes assessments are completed at baseline and every 6 months. Both interventions focus on exercise, diet, cognitive/social stimulation, and cardiovascular health, but differ in intensity and accountability. The study partners with a worldwide network of similar trials for harmonization of methods and data sharing. DISCUSSION U.S. POINTER is testing a potentially sustainable intervention to support brain health and Alzheimer's prevention for Americans. Impact is strengthened by the targeted participant diversity and expanded scientific scope through ancillary studies.
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Affiliation(s)
- Laura D. Baker
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
- Wake Forest University School of MedicineDivision of Public Health SciencesWinston SalemNorth CarolinaUSA
- Wake Forest University School of MedicineDepartment of NeurologyWinston SalemNorth CarolinaUSA
| | | | - Mark A. Espeland
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
- Wake Forest University School of MedicineDivision of Public Health SciencesWinston SalemNorth CarolinaUSA
| | - Rachel A. Whitmer
- University of California DavisDepartment of Public Health SciencesSacramentoCaliforniaUSA
| | - Miia Kivipelto
- Karolinska Institute, Division of Clinical GeriatricsCenter for Alzheimer ResearchStockholmSweden
- University of Eastern FinlandInstitute of Public Health and Clinical NutritionKuopioFinland
- Imperial College London, School of Public HealthAgeing Epidemiology Research UnitLondonUK
- FINGERS Brain Health InstituteStockholmSweden
| | - Nancy Woolard
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
| | - Jeffrey Katula
- Wake Forest UniversityDepartment of Health and Exercise ScienceWinston SalemNorth CarolinaUSA
| | - Kathryn V. Papp
- Brigham and Women's HospitalDepartment of NeurologyBostonMassachusettsUSA
- Massachusetts General HospitalDepartment of NeurologyBostonMassachusettsUSA
- Harvard Medical SchoolDepartment of NeurologyBostonMassachusettsUSA
| | - Jennifer Ventrelle
- Rush University Medical Center, Departments of Clinical Nutritionand Family and Preventive MedicineChicagoIllinoisUSA
| | - Sarah Graef
- Rush University Medical Center, Departments of Clinical Nutritionand Family and Preventive MedicineChicagoIllinoisUSA
| | - Marcus A. Hill
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
| | - Scott Rushing
- Wake Forest University School of MedicineDivision of Public Health SciencesWinston SalemNorth CarolinaUSA
| | - Julia Spell
- Wake Forest University School of MedicineDivision of Public Health SciencesWinston SalemNorth CarolinaUSA
| | - Laura Lovato
- Wake Forest University School of MedicineDivision of Public Health SciencesWinston SalemNorth CarolinaUSA
| | - Deborah Felton
- Wake Forest University School of MedicineDivision of Public Health SciencesWinston SalemNorth CarolinaUSA
| | - Benjamin J. Williams
- Wake Forest University School of MedicineDepartment of NeurologyWinston SalemNorth CarolinaUSA
| | - Mina Ghadimi Nouran
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
| | - Rema Raman
- University of Southern CaliforniaAlzheimer's Therapeutic Research InstituteSan DiegoCaliforniaUSA
| | - Tiia Ngandu
- Karolinska Institute, Division of Clinical GeriatricsCenter for Alzheimer ResearchStockholmSweden
- Finnish Institute for Health and WelfareDepartment of Public Health and WelfareHelsinkiFinland
| | - Alina Solomon
- Karolinska Institute, Division of Clinical GeriatricsCenter for Alzheimer ResearchStockholmSweden
- Imperial College London, School of Public HealthAgeing Epidemiology Research UnitLondonUK
- FINGERS Brain Health InstituteStockholmSweden
- University of Eastern FinlandInstitute of Clinical Medicine/NeurologyKuopioFinland
| | - Sharon Wilmoth
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
| | - Maryjo L. Cleveland
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
| | - Jeff D. Williamson
- Wake Forest University School of MedicineDepartment of Internal MedicineWinston SalemNorth CarolinaUSA
| | | | | | - Claire E. Day
- Alzheimer's AssociationNorthern California Northern Nevada ChapterSan JoseCaliforniaUSA
| | - Christy C. Tangney
- University of Southern CaliforniaAlzheimer's Therapeutic Research InstituteSan DiegoCaliforniaUSA
| | - Darren R. Gitelman
- Advocate Health CareDepartment of Behavioral NeurologyDowners GroveIllinoisUSA
| | - Olivia Matongo
- Alzheimer's AssociationIllinois ChapterChicagoIllinoisUSA
| | | | - Valory N. Pavlik
- Baylor College of MedicineDepartment of NeurologyHoustonTexasUSA
| | - Melissa M. Yu
- Baylor College of MedicineDepartment of NeurologyHoustonTexasUSA
| | | | - Richard Elbein
- Alzheimer's AssociationHouston & Southeast Texas ChapterHoustonTexasUSA
| | | | - Stephen Salloway
- Butler Hospital, Memory and Aging Programand Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Rena R. Wing
- Brown University, Department of Psychiatry and Human BehaviorSchool of MedicineProvidenceRhode IslandUSA
| | - Susan Antkowiak
- Alzheimer's AssociationRhode Island ChapterProvidenceRhode IslandUSA
| | - Martha Clare Morris
- Rush University Medical Center, Departments of Clinical Nutritionand Family and Preventive MedicineChicagoIllinoisUSA
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Ferguson L, Sain D, Kürüm E, Strickland-Hughes CM, Rebok GW, Wu R. One-year cognitive outcomes from a multiple real-world skill learning intervention with older adults. Aging Ment Health 2023; 27:2134-2143. [PMID: 37059695 DOI: 10.1080/13607863.2023.2197847] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 03/21/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES Novel skill learning has been shown to have cognitive benefits in the short-term (up to a few months). Two studies expanded on prior research by investigating whether learning multiple novel real-world skills simultaneously (e.g. Spanish, drawing, music composition), for a minimum of six hours a week, would yield 1-year cognitive gains. METHOD Following a 3-month multi-skill learning intervention, Study 1 (N = 6, Mage = 66 years, SDage = 6.41) and Study 2 (N = 27, Mage = 69 years, SDage = 7.12) participants completed follow-up cognitive assessments 3 months, 6 months, and one year after the intervention period. Cognitive assessments tested executive function (working memory and cognitive control) and verbal episodic memory. RESULTS Linear mixed-effects models revealed improvements in multiple cognitive outcomes from before the intervention to the follow-up timepoints. Specifically, executive function increased from pre-test to the 1-year follow-up for both studies (an effect driven mostly by cognitive control scores). DISCUSSION Our findings provide evidence that simultaneously learning real-world skills can lead to long-term improvements in cognition during older adulthood. Future work with diverse samples could investigate individual differences in gains. Overall, our findings promote the benefits of lifelong learning, namely, to improve cognitive abilities in older adulthood.
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Affiliation(s)
- Leah Ferguson
- Department of Psychology, UC Riverside, Riverside, CA, USA
| | - Debaleena Sain
- Department of Statistics, UC Riverside, Riverside, CA, USA
| | - Esra Kürüm
- Department of Statistics, UC Riverside, Riverside, CA, USA
| | | | - George W Rebok
- Bloomberg School of Public Health and Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rachel Wu
- Department of Psychology, UC Riverside, Riverside, CA, USA
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25
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Burnett LK, Richmond LL. Just write it down: Similarity in the benefit from cognitive offloading in young and older adults. Mem Cognit 2023; 51:1580-1592. [PMID: 36995572 DOI: 10.3758/s13421-023-01413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 03/31/2023]
Abstract
Past research conducted primarily in young adults has demonstrated the utility of cognitive offloading for benefitting performance of memory-based tasks, particularly at high memory loads. At the same time, older adults show declines in a variety of memory abilities, including subtle changes in short-term memory, suggesting that cognitive offloading could also benefit performance of memory-based tasks in this group. To this end, 94 participants (62 young adults, 32 older adults) were tested on a retrospective audiovisual short-term memory task in two blocked conditions. Offloading was permitted in the offloading choice condition but not in the internal memory condition. Performance was improved for both age groups in the offloading choice condition compared to the internal memory condition. Moreover, the choice to use the offloading strategy was similar across age groups at high memory loads, and use of the offloading strategy benefitted performance for young and older adults similarly. These data suggest that older adults can make effective use of cognitive offloading to rescue performance of memory-based activities, and invites future research on the benefits of cognitive offloading for older adults in other, more complex tasks where age-related memory impairment is expected to be more prominent.
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Affiliation(s)
- Lois K Burnett
- Department of Psychology, Stony Brook University, Psychology B Building, Stony Brook, NY, 11794, USA
| | - Lauren L Richmond
- Department of Psychology, Stony Brook University, Psychology B Building, Stony Brook, NY, 11794, USA.
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26
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Rebok GW, Clay OJ, Thorpe RJ, Willis SL. The ACTIVE Study: Association of Race and Social Determinants of Health (SDoH) with Long-Term Outcomes and Cognitive Training Effects. J Aging Health 2023; 35:3S-10S. [PMID: 37994854 DOI: 10.1177/08982643231204931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objective: The purpose of this article is to introduce a special issue on the ACTIVE project examining the association between race and social determinants of health (SDoH) and long-term participant outcomes and training effectiveness for older Black/African Americans and Whites in the ACTIVE (for Advanced Cognitive Training for Independent and Vital Elderly) Trial on cognitive abilities, everyday functioning, and incidence of dementia. The ACTIVE study is the largest randomized clinical trial (N = 2802) of the efficacy of three types of cognitive training (memory, reasoning, speed of processing) in improving cognitive and everyday functioning in normal older adults, with follow-ups extending through 5 and 10 years post-intervention. Method: We provide background and context for studying the multiple domains of SDoH in understanding long-term participant outcomes in the ACTIVE trial and racial disparities in the efficacy of cognitive training and summarize the 11 articles in this special issue. Results: Articles in this special issue address several cross-cutting themes. These include 1) a focus on SDoH and race in relation to three cognitive abilities and driving; 2) cognitive training outcomes in older Black/African Americans (B/AA); 3) race differences in everyday function; and 4) associations of various risk factors (e.g., cardiovascular disease, obesity, depression) and protective factors (e.g., occupational complexity) for cognitive decline with health disparities in incident dementia and mortality. Conclusion: In cognitive training studies with cognitively healthy older adults, it is important to consider how factors such as race and SDoH relate to long-term participant outcomes and how they moderate intervention effects.
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Affiliation(s)
- George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- Deep South Resource Center for Minority Aging Research, Birmingham, AL, USA
- UAB Alzheimer's Disease Research Center, Birmingham, AL, USA
| | - Roland J Thorpe
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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27
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Aiken-Morgan AT, McDonough IM, Parisi JM, Clay OJ, Thomas KR, Rotblatt LJ, Thorpe RJ, Marsiske M. Associations Between Body Mass Index and Cognitive Change in the ACTIVE Study: Variations by Race and Social Determinants of Health. J Aging Health 2023; 35:59S-73S. [PMID: 37994849 DOI: 10.1177/08982643221109645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objectives: The current study examines relationships between Body Mass Index (BMI) and cognitive performance and change in processing speed, memory, and reasoning, while accounting for variations by race and the influence of social determinants of health. Methods: Secondary data analysis of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, which included participants who self-identified as African American or Black (n = 728) and White (n = 2028). Latent growth curve modeling was used to assess study aims. Results: Increases in BMI were associated with less cognitive decline over 10 years across each cognition domain. Race moderation effects were noted for speed and memory. Relationships between BMI and cognitive trajectories were mediated by economic stability for speed and reasoning. Discussion: Overall, these findings are consistent with the "obesity paradox." Further research is needed to elucidate patterns of results by race.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Department of Psychiatry, University of North Carolina - Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Ian M McDonough
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama, Birmingham, AL, USA
| | - Kelsey R Thomas
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Lindsay J Rotblatt
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Roland J Thorpe
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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28
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Nanousi V, Kalogeraki K, Smyrnaiou A, Tola M, Bokari F, Georgopoulos VC. The Development of a Pilot App Targeting Short-Term and Prospective Memory in People Diagnosed with Dementia. Behav Sci (Basel) 2023; 13:752. [PMID: 37754030 PMCID: PMC10525938 DOI: 10.3390/bs13090752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND According to the World Health Organization, people suffering from dementia exhibit a serious decline in various cognitive domains and especially in memory. AIMS This study aims to create a pilot computer app to enhance short-term memory and prospective memory in individuals with dementia using errorless learning based on their individualized needs. METHODS Fifteen dementia patients and matched controls, matched for age, sex, and education, were selected. Their daily routines were analyzed, and cognitive abilities were assessed using the MoCA test. Considering the participants' illness severity and daily needs, the pilot app was designed to aid in remembering daily tasks (taking medication and meals), object locations, and familiar faces and names. RESULTS An improvement in patients' short-term and prospective memory throughout the training sessions, but not in overall cognitive functioning was observed. A statistically significant difference between patients and healthy controls was indicated in their ability to retain information relevant to them in their short-term memory, or to remember to act in the future following schedules organized at present (p < 0.001). CONCLUSION This app appears beneficial for training dementia patients and healthy individuals in addressing memory challenges. RECOMMENDATION While the pilot app showed promise, further research with larger samples is recommended.
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Affiliation(s)
- Vicky Nanousi
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Konstantina Kalogeraki
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Aikaterini Smyrnaiou
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Manila Tola
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Foteini Bokari
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Voula Chris Georgopoulos
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
- Primary Health Care Laboratory, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
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29
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Borella E, Sella E, Simonetto A, Bellorio N, Lenti G, Taconnat L, Carbone E. Effects of Strategy-Based Memory Training for Older Adults: Do Booster Sessions Prompt Long-Term Benefits? Brain Sci 2023; 13:1301. [PMID: 37759902 PMCID: PMC10526930 DOI: 10.3390/brainsci13091301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
This study examined the efficacy of a strategy-based memory training for older adults at short- and long-term with two (5- and 11 months) follow-ups. We also explored whether booster sessions (additional training before the first follow-up) facilitated the maintenance of benefits. Thirty-three older adults received a training based on the teaching of different effective memory strategies. One group completed three booster sessions before the 5 months follow-up. Training gains were examined using a word-list and a face-surname association recall tasks, and transfer effects with a grocery-word list (GL) recall task, a working memory (WM) measure, and a perceived memory functioning questionnaire. Training gains and transfer effects to the WM measure emerged and were maintained up to the second follow-up. No benefits for the GL and perceived memory functioning were found. The "boosted" group had only a slight advantage-in one of the transfer tasks-as shown by effect sizes. This pilot study confirms the efficacy of strategy-based memory training in supporting older adults' memory performance up to 11 months since training completion. However, booster sessions seem not to make a clear difference in prompting long-lasting benefits. Training features capable of fostering generalized, prolonged effects are worth investigating.
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Affiliation(s)
- Erika Borella
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Enrico Sella
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Anna Simonetto
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Nicola Bellorio
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Graziana Lenti
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Laurence Taconnat
- Université de Poitiers et Centre de Recherches sur la Cognition et l’Apprentissage, Université de Tours, UMR-CNRS 7295, 37000 Tours, France;
| | - Elena Carbone
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
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Sanz Simon S, Ben-Eliezer D, Pondikos M, Stern Y, Gopher D. Feasibility and acceptability of a new web-based cognitive training platform for cognitively healthy older adults: the breakfast task. Pilot Feasibility Stud 2023; 9:136. [PMID: 37542331 PMCID: PMC10401737 DOI: 10.1186/s40814-023-01359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/05/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Developing efficient cognitive training for the older population is a major public health goal due to its potential cognitive benefits. A promising training target is executive control, critical for multitasking in everyday life. The aim of this pilot study was to establish the feasibility and acceptability of the Breakfast Task training in older adults, a new web-based cognitive training platform that simulates real-life multitasking demands. METHODS A community-based sample of 24 cognitively healthy participants aged between 60 and 75 (M = 69.12, SD = 3.83) underwent 5-session cognitive training protocol, delivered online. Each session lasted 45 min and occurred twice a week at participant's homes. Performance was recorded, and participants completed questionnaires at baseline and after the intervention. RESULTS Feasibility metrics showed overall high recruitment (82.7%), adherence and retention rates (100%). Acceptability was considered good based on participant's quantitative and qualitative responses. On average, participants rated the game as interesting, enjoyable and did not report difficulties in accessing the game online without supervision or in understanding the instructions. Participants showed a learning curve across sessions, suggesting improvement in the game outcomes and potential benefits from the emphasis change training approach. The study identified relevant areas that need improvements and adjustments, such as technical issues, session's structure, and dose. CONCLUSIONS The findings provide preliminary support for the feasibility and acceptability of the web-based Breakfast Task training platform in cognitively healthy older adults. Results suggest the value of further research to investigate the Breakfast Task training features and dose-response relationship, as well as its potential efficacy in older adults via larger randomized controlled trials. TRIAL REGISTRATION ClinicalTrials.gov: NCT04195230 (Registered 11 December 2019).
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Affiliation(s)
- Sharon Sanz Simon
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA.
| | - Daniel Ben-Eliezer
- Faculty of Industrial Engineering and Management Technion, Israel Institute of Technology, Technion city, Haifa, 32000, Israel
| | - Maria Pondikos
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Yaakov Stern
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Daniel Gopher
- Faculty of Industrial Engineering and Management Technion, Israel Institute of Technology, Technion city, Haifa, 32000, Israel
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Tam JW, Khurshid K, Sprague B, Clark DO, Xu H, Moser LR, Miller DK, Considine R, Callahan CM, Garringer HJ, Rexroth D, Unverzagt FW. Design and baseline characteristics of the Cognitive and Aerobic Resilience for the Brain (CARB) study. Contemp Clin Trials 2023; 131:107249. [PMID: 37268243 PMCID: PMC10527227 DOI: 10.1016/j.cct.2023.107249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/15/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Treatments that delay progression of cognitive impairment in older adults are of great public health significance. This manuscript outlines the protocol, recruitment, baseline characteristics, and retention for a randomized controlled trial of cognitive and aerobic physical training to improve cognition in individuals with subjective cognitive dysfunction, the "Cognitive and Aerobic Resilience for the Brain" (CARB) study. METHODS Community-dwelling, older adults with self-reported memory loss were randomly assigned to receive either computer-based cognitive training, aerobic physical training, combined cognitive and physical training, or education control. Treatment was delivered 2- to 3-times per week in 45- to 90-min sessions for 12 weeks by trained facilitators videoconferencing into subject's home. Outcome assessments of were taken at the baseline, immediately following training, and 3-months after training. RESULTS 191 subjects were randomized into the trial (mean age, 75.5 years; 68% female; 20% non-white; mean education, 15.1 years; 30% with 1+ APOE e4 allele). The sample was generally obese, hypertensive, and many were diabetic, while cognition, self-reported mood, and activities of daily living were in the normal range. There was excellent retention throughout the trial. Interventions were completed at high rates, participants found the treatments acceptable and enjoyable, and outcome assessments were completed at high rates. CONCLUSIONS This study was designed to determine the feasibility of recruiting, intervening, and documenting response to treatment in a population at risk for progressive cognitive decline. Older adults with self-reported memory loss were enrolled in high numbers and were well engaged with the intervention and outcome assessments.
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Affiliation(s)
- Joyce W Tam
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Kiran Khurshid
- Department of Neurology, Indiana University School of Medicine, United States of America
| | - Briana Sprague
- Department of Medicine, Indiana University School of Medicine, United States of America; Indiana University Center for Aging Research at Regenstrief Institute, United States of America
| | - Daniel O Clark
- Department of Medicine, Indiana University School of Medicine, United States of America; Indiana University Center for Aging Research at Regenstrief Institute, United States of America
| | - Huiping Xu
- Department of Biostatistics, Indiana University School of Medicine, United States of America
| | - Lyndsi R Moser
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Douglas K Miller
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, United States of America
| | - Robert Considine
- Department of Medicine, Indiana University School of Medicine, United States of America
| | | | - Holly J Garringer
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, United States of America
| | - Daniel Rexroth
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Frederick W Unverzagt
- Department of Psychiatry, Indiana University School of Medicine, United States of America.
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Wu Z, Pandigama DH, Wrigglesworth J, Owen A, Woods RL, Chong TTJ, Orchard SG, Shah RC, Sheets KM, McNeil JJ, Murray AM, Ryan J. Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. JAMA Netw Open 2023; 6:e2323690. [PMID: 37450299 PMCID: PMC10349343 DOI: 10.1001/jamanetworkopen.2023.23690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/31/2023] [Indexed: 07/18/2023] Open
Abstract
Importance Lifestyles enriched with socially and mentally stimulating activities in older age may help build cognitive reserve and reduce dementia risk. Objective To investigate the association of leisure activities and social networks with dementia risk among older individuals. Design, Setting, and Participants This longitudinal prospective cohort study used population-based data from the ASPREE Longitudinal Study of Older Persons (ALSOP) for March 1, 2010, to November 30, 2020. Community-dwelling individuals in Australia aged 70 years or older who were generally healthy and without major cognitive impairment at enrollment were recruited to the ALSOP study between March 1, 2010, and December 31, 2014. Data were analyzed from December 1, 2022, to March 31, 2023. Exposures A total of 19 measures of leisure activities and social networks assessed at baseline were classified using exploratory factor analysis. Main Outcomes and Measures Dementia was adjudicated by an international expert panel according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Cox proportional hazards regression examined dementia risk over 10 years, adjusting for education, socioeconomic status, and a range of health-related factors. Results This study included 10 318 participants. Their median age was 73.8 (IQR, 71.6-77.2) years at baseline, more than half (52.6%) were women, and most self-identified as White (98.0%). In adusted analyses, more frequent engagement in adult literacy activities (eg, writing letters or journaling, using a computer, and taking education classes) and in active mental activities (eg, playing games, cards, or chess and doing crosswords or puzzles) was associated with an 11.0% (adjusted hazard ratio [AHR], 0.89 [95% CI, 0.85-0.93]) and a 9.0% (AHR, 0.91 [95% CI, 0.87-0.95]) lower risk of dementia, respectively. To a lesser extent, engagement in creative artistic activities (craftwork, woodwork, or metalwork and painting or drawing) (AHR, 0.93 [95% CI, 0.88-0.99]) and in passive mental activities (reading books, newspapers, or magazines; watching television; and listening to music or the radio) (AHR, 0.93 [95% CI, 0.86-0.99]) was also associated with reduced dementia risk. In contrast, interpersonal networks, social activities, and external outings were not associated with dementia risk in this sample. Conclusions and Relevance These results suggest that engagement in adult literacy, creative art, and active and passive mental activities may help reduce dementia risk in late life. In addition, these findings may guide policies for geriatric care and interventions targeting dementia prevention for older adults.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Danushika H. Pandigama
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Monash School of Medicine, Monash University, Melbourne, Australia
| | - Jo Wrigglesworth
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Trevor T.-J. Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
- Department of Clinical Neurosciences, St Vincent’s Hospital, Melbourne, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Raj C. Shah
- Department of Family and Preventive Medicine, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Kerry M. Sheets
- Division of Geriatric and Palliative Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis, Minnesota
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Phillips CB, McVey A, Tian J, Stephan AT, Davis WB, Aflagah EL, Ross LA. Feasibility of a pilot dyadic randomized controlled trial testing the effects of three behavioral interventions on older adults' cognitive, physical and everyday function. FRONTIERS IN AGING 2023; 4:1166338. [PMID: 37305226 PMCID: PMC10248235 DOI: 10.3389/fragi.2023.1166338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023]
Abstract
Introduction: Maintaining functional abilities is critical for optimizing older adults' well-being and independence. This randomized controlled trial (RCT) pilot examined the feasibility of testing the effects of three commercially available interventions on function-related outcomes in older adults. Methods: Pairs of community-dwelling older adults (N=55, Mage=71.4) were randomized to a 10-week intervention (cognitive-COG, physical-EX, combined exergame-EXCOG, or control-CON). Cognitive, physical, and everyday function were assessed at baseline, immediately post-intervention, and 6-months post-intervention. Feasibility was evaluated using recruitment, enrollment, training adherence, and retention metrics. Variability and patterns of change in functional outcomes were examined descriptively. Results: A total of 208 individuals were screened, with 26% subsequently randomized. Across training arms, 95% of training sessions were completed and 89% of participants were retained at immediate post-test. Variability in functional outcomes and patterns of change differed across study arms. Discussion: Results support a fully powered RCT, with several modifications to the pilot study design, to investigate short- and long-term training impacts.
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Affiliation(s)
- Christine B. Phillips
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - Ava McVey
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - Junyan Tian
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, United States
| | - Abigail T. Stephan
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - W. Bennett Davis
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Erica L. Aflagah
- Department of Neurology, Neuropsychology Division, University of Nebraska Medical Center, Omaha, NE, United States
| | - Lesley A. Ross
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
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Nath K, Ferguson I, Puleio A, Wall K, Stark J, Clark S, Story C, Cohen B, Anderson-Hanley C. Brain Health Indicators Following Acute Neuro-Exergaming: Biomarker and Cognition in Mild Cognitive Impairment (MCI) after Pedal-n-Play (iPACES). Brain Sci 2023; 13:844. [PMID: 37371324 DOI: 10.3390/brainsci13060844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Facing an unrelenting rise in dementia cases worldwide, researchers are exploring non-pharmacological ways to ameliorate cognitive decline in later life. Twenty older adults completed assessments before and after a single bout of interactive physical and cognitive exercise, by playing a neuro-exergame that required pedaling and steering to control progress in a tablet-based video game tailored to impact executive function (the interactive Physical and Cognitive Exercise System; iPACES v2). This study explored the cognitive and biomarker outcomes for participants with mild cognitive impairment (MCI) and normative older adults after 20 min of pedal-to-play exercise. Neuropsychological and salivary assessments were performed pre- and post-exercise to assess the impact. Repeated-measures ANOVAs revealed significant interaction effects, with MCI participants experiencing greater changes in executive function and alpha-amylase levels than normative older adults; within-group changes were also significant. This study provides further data regarding cognitive effects and potential mechanisms of action for exercise as an intervention for MCI.
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Affiliation(s)
- Kartik Nath
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | | | - Alexa Puleio
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Kathryn Wall
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Jessica Stark
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Sean Clark
- Gordon College, 255 Grapevine Rd, Wenham, MA 01984, USA
| | - Craig Story
- Gordon College, 255 Grapevine Rd, Wenham, MA 01984, USA
| | - Brian Cohen
- Union College, 807 Union Street, Schenectady, NY 12308, USA
| | - Cay Anderson-Hanley
- Union College, 807 Union Street, Schenectady, NY 12308, USA
- iPACES LLC, 56 Clifton Country Road, Suite 104 (Box#11), Clifton Park, NY 12065, USA
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Tian Q, Montero-Odasso M, Buchman AS, Mielke MM, Espinoza S, DeCarli CS, Newman AB, Kritchevsky SB, Rebok GW, Resnick SM, Thambisetty M, Verghese J, Ferrucci L. Dual cognitive and mobility impairments and future dementia - Setting a research agenda. Alzheimers Dement 2023; 19:1579-1586. [PMID: 36637077 PMCID: PMC10101877 DOI: 10.1002/alz.12905] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 01/14/2023]
Abstract
Dual cognitive and mobility impairments are associated with an increased risk of dementia. Recent studies examining temporal trajectories of mobility and cognitive function in aging found that dual decline is associated with higher dementia risk than memory decline or gait decline only. Although initial data show that individuals with dual decline or impairment have excessive cardiovascular and metabolic risk factors, the causes of dual decline or what underlies dual decline with a high risk of dementia remain largely unknown. In December 2021, the National Institute on Aging Intramural and Extramural Programs jointly organized a workshop on Biology Underlying Moving and Thinking to explore the hypothesis that older persons with dual decline may develop dementia through a specific pathophysiological pathway. The working group discussed assessment methods for dual decline and possible mechanisms connecting dual decline with dementia risk and pinpointed the most critical questions to be addressed from a translational perspective.
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Affiliation(s)
- Qu Tian
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Manuel Montero-Odasso
- Schulich School of Medicine and Dentistry, Department of Medicine and Division of Geriatric Medicine, The University of Western Ontario, London, ON, Canada
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, ON, Canada
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sara Espinoza
- Division of Geriatrics, Gerontology & Palliative Medicine, Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, TX, USA
- Geriatrics Research, Education and Clinical Center, South Texas Veterans Health Care System, Audie Murphy Veterans Hospital, San Antonio, TX, USA
| | | | - Anne B. Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen B. Kritchevsky
- Department of Internal Medicine: Gerontology & Geriatric Medicine, The Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - George W. Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Madhav Thambisetty
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
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Cortes RA, Weinberger AB, Green AE. The Mental Models Training App: Enhancing verbal reasoning through a cognitive training mobile application. Front Psychol 2023; 14:1150210. [PMID: 36968736 PMCID: PMC10036765 DOI: 10.3389/fpsyg.2023.1150210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionReasoning is a complex form of human cognition whose nature has long been debated. While a number of neurocognitive mechanisms for deductive reasoning have been offered, one of the most prominent accounts is Mental Model Theory (MMT). According to MMT, humans are able to manipulate and represent information for reasoning and problem solving by leveraging the brain’s evolved visuospatial resources. Thus, when solving deductive reasoning problems, reasoners build “mental models” of the essential pieces of information conveyed in the premises, with their relations to each other represented spatially—even when the information contained within a reasoning problem is not intrinsically spatial. Crucially, taking a spatially-based approach, such as building mental models, supports higher accuracy on deductive reasoning problems. However, no study has empirically tested whether explicitly training this mental modeling ability leads to improved deductive reasoning performance.MethodTherefore, we designed the Mental Models Training App, a cognitive training mobile application which requires participants to complete increasingly difficult reasoning problems while using an external mental modeling tool. In this preregistered study (https://osf.io/4b7kn), we conducted a between-subjects experiment (N = 301) which compared the Mental Models Training App to 3 distinct control conditions in order to examine which specific components (if any) of the training were causally responsible for improved reasoning performance.ResultsResults demonstrate that, when compared to a passive control condition, the Mental Models Training App led to improvements in adults’ verbal deductive reasoning performance both during and after the training intervention. However, contrary to our preregistered hypotheses, the training-induced improvements were not significantly larger than the effects of the active control conditions—one which included adaptive practice of the reasoning problems, and one which included adaptive practice as well as a spatial alphabetization control task.DiscussionTherefore, while the present results demonstrate the ability of the Mental Models Training App to enhance verbal deductive reasoning, they do not support the hypothesis that directly training participants mental modeling ability yields improved performance beyond the effects of adaptive practice of reasoning. Future research should examine the long-term effects of repeated usage of the Mental Models Training App, as well as transfer effects to other forms of reasoning. Finally, we present the Mental Models Training App as a free mobile application available on the Apple App store (https://apps.apple.com/us/app/mental-models-training/id1664939931), in the hope that this translational research may be utilized by the general public to improve their reasoning ability.
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Affiliation(s)
- Robert A. Cortes
- Department of Psychology, Georgetown University, Washington, DC, United States
- *Correspondence: Robert A. Cortes,
| | - Adam B. Weinberger
- Department of Psychology, Georgetown University, Washington, DC, United States
| | - Adam E. Green
- Department of Psychology, Georgetown University, Washington, DC, United States
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States
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Makri M, Christakidou A, Tsolaki M. A Novel Method of Teaching English to People with Mild Cognitive Impairment Using Songs: A Randomized Controlled Trial Protocol. J Alzheimers Dis 2023; 92:529-546. [PMID: 36776046 PMCID: PMC10041446 DOI: 10.3233/jad-220184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND People with mild cognitive impairment (MCI) need to prevent the further decline of their cognitive functions, and one way to do so is by learning a foreign language. OBJECTIVE This study describes the development of a protocol for a novel, non-pharmacological intervention for people with MCI that seeks to prevent or reduce cognitive decline by teaching English through songs. METHODS The development of this protocol follows a mixed-methodology approach, consisting of three stages: 1) development of the protocol of the intervention, 2) a randomized controlled trial study with two arms over six months that includes an intervention group and a control group, and 3) the evaluation of the protocol by trainers. In the second stage, we recruited a total of 128 people with MCI from the five participating countries of this study (Greece, Spain, Croatia, Slovenia, and Italy). This educational program will assess three main outcomes after 6 months of the English Lessons with the Use of Songs for People with Mild Cognitive Impairment (E.L.So.M.C.I.) workshops. RESULTS Our primary outcome will hopefully be an improvement in general cognition in the intervention group compared to the control group from baseline to 6 months follow-up. Secondary outcomes include a decrease in participants' anxiety and depression and an improvement in their quality of life. Development of English language skills is the last outcome.
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Affiliation(s)
- Marina Makri
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Faculty of Medicine, School of Neuroscience, Thessaloniki, Greece
| | - Alexandra Christakidou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Faculty of Philosophy, School of English Language and Literature, Thessaloniki, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Faculty of Medicine, School of Neuroscience, Thessaloniki, Greece
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Predictors of cognitive functioning trajectories among older Americans: A new investigation covering 20 years of age- and non-age-related cognitive change. PLoS One 2023; 18:e0281139. [PMID: 36753483 PMCID: PMC9907834 DOI: 10.1371/journal.pone.0281139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023] Open
Abstract
Despite the extensive study of predictors of cognitive decline in older age, a key uncertainty is how much these predictors explain both the intercept and age- and non-age-related change in cognitive functioning (CF). We examined the contribution of a broad range of life course determinants to CF trajectories. Data came from 7,068 participants in the 1996-2016 Health and Retirement Study. CF was measured as a summary score on a 27-point cognitive battery of items. We estimated multilevel growth curve models to examine the CF trajectories in individuals ages 54-85. We found that the variation in CF level at age 54 was three times as much as the variation in age slope. All the observed individual predictors explained 38% of the variation in CF at age 54. Personal education was the most important predictor (25%), followed by race, household wealth and income, parental education, occupation, and depression. The contributions of activity limitations, chronic diseases, health behaviors (obesity, smoking, vigorous activity), childhood conditions (childhood health, nutrition, financial situation), gender, marital status, and religion were rather small (<5%). Even though the age slope varied with many adulthood factors, they only explained 5.6% of the between-person variation in age slope. Moreover, age explained 23% of within-person variation in CF from age 54 to 85. The rest non-age-related within-person variation could not be explained by the observed time-varying factors. These findings suggest that future research is urgently needed to discover the main determinants of the slope of cognitive decline to slow down the progression of cognitive impairment and dementia.
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Sorond FA, Gorelick PB. Brain Reserve, Resilience, and Cognitive Stimulation Across the Lifespan: How Do These Factors Influence Risk of Cognitive Impairment and the Dementias? Clin Geriatr Med 2023; 39:151-160. [PMID: 36404028 DOI: 10.1016/j.cger.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the absence of effective treatments for dementia, maintaining cognitive health in old age is one of the major challenges facing aging societies. Interventions for cognitive health that are tailored to the person are more likely to bring the best benefits with a minimum burden. We review the existing literature on this topic and discuss the role of the primary care physician.
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Affiliation(s)
- Farzaneh A Sorond
- Department of Neurology, Division of Stroke, Northwestern University, Feinberg School of Medicine, 625 North Michigan Avenue, 11th Floor, Chicago, IL 60611, USA.
| | - Philip B Gorelick
- Department of Neurology, Division of Stroke, Northwestern University, Feinberg School of Medicine, 625 North Michigan Avenue, 11th Floor, Chicago, IL 60611, USA
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Sheth S, Cogle CR. Home Modifications for Older Adults: A Systematic Review. J Appl Gerontol 2023; 42:1151-1164. [PMID: 36655622 DOI: 10.1177/07334648231151669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
While ≧10,000 Americans turn 65 years old every day, only 10% of American homes are "aging ready." Unsafe homes can exacerbate disability, lead to falls, and increase the likelihood of hospitalization. With increased investments in home and community-based services, public health stakeholders are considering home modifications to promote successful aging. While several home modification models exist, there is significant heterogeneity between models and no consensus on critical features. PubMed, EMBASE, and Web of Science were reviewed and twelve randomized controlled trials of home modifications for older adults were identified and evaluated for model structure, reported outcomes, and risk of bias. Overall, occupational therapist-driven home modifications supplemented with clinical, physical activity, and/or behavioral components saw the greatest success. This systematic review discusses the components of these models, highlights particularly effective and frequently used features, and the practice and research needed to create effective next-generation home modification models which promote healthy longevity.
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Affiliation(s)
- Sohum Sheth
- College of Medicine, 12233University of Florida, Gainesville, FL, USA
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Gohari N, Dastgerdi ZH, Rouhbakhsh N, Afshar S, Mobini R. Training Programs for Improving Speech Perception in Noise: A Review. J Audiol Otol 2023; 27:1-9. [PMID: 36710414 PMCID: PMC9884994 DOI: 10.7874/jao.2022.00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/26/2022] [Indexed: 01/20/2023] Open
Abstract
Understanding speech in the presence of noise is difficult and challenging, even for people with normal hearing. Accurate pitch perception, coding and decoding of temporal and intensity cues, and cognitive factors are involved in speech perception in noise (SPIN); disruption in any of these can be a barrier to SPIN. Because the physiological representations of sounds can be corrected by exercises, training methods for any impairment can be used to improve speech perception. This study describes the various types of bottom-up training methods: pitch training based on fundamental frequency (F0) and harmonics; spatial, temporal, and phoneme training; and top-down training methods, such as cognitive training of functional memory. This study also discusses music training that affects both bottom-up and top-down components and speech training in noise. Given the effectiveness of all these training methods, we recommend identifying the defects underlying SPIN disorders and selecting the best training approach.
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Affiliation(s)
- Nasrin Gohari
- Hearing Disorders Research Center, Department of Audiology, School of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Hosseini Dastgerdi
- Department of Audiology, School of Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence Zahra Hosseini Dastgerdi, PhD Department of Audiology, School of Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran Tel +98-09132947800 Fax +98-(311)5145-668 E-mail
| | - Nematollah Rouhbakhsh
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Afshar
- Hearing Disorders Research Center, Department of Audiology, School of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Razieh Mobini
- Hearing Disorders Research Center, Department of Audiology, School of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran
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Liu LY, Xing Y, Zhang ZH, Zhang QG, Dong M, Wang H, Cai L, Wang X, Tang Y. Validation of a Computerized Cognitive Training Tool to Assess Cognitive Impairment and Enable Differentiation Between Mild Cognitive Impairment and Dementia. J Alzheimers Dis 2023; 96:93-101. [PMID: 37742644 DOI: 10.3233/jad-230416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Age-related cognitive decline is a chronic, progressive process that requires active clinical management as cognitive status changes. Computerized cognitive training (CCT) provides cognitive exercises targeting specific cognitive domains delivered by computer or tablet. Meanwhile, CCT can be used to regularly monitor the cognitive status of patients, but it is not clear whether CCT can reliably assess cognitive ability or be used to diagnose different stages of cognitive impairment. OBJECTIVE To investigate whether CCT can accurately monitor the cognitive status of patients with cognitive impairment as well as distinguish patients with dementia from patients with mild cognitive impairment (MCI). METHOD We included 116 patients (42 dementia and 74 MCI) in final analysis. Cognitive ability was assessed by averaging the patient performance on the CCT to determine the Cognitive Index. The validity of the Cognitive Index was evaluated by its correlation with neuropsychological tests, and internal consistency was measured to assess the reliability. Additionally, we determined the diagnostic ability of the Cognitive Index to detect dementia using receiver operating characteristic (ROC) analysis. RESULTS The Cognitive Index was highly correlated with the Montreal Cognitive Assessment (r = 0.812) and the Mini-Mental State Examination (r = 0.694), indicating good convergent validity, and the Cronbach's alpha coefficient was 0.936, indicating excellent internal consistency. The area under the ROC curve, sensitivity, and specificity of the Cognitive Index to diagnose dementia were 0.943, 83.3%, and 91.9%, respectively. CONCLUSIONS CCT can be used to assess cognitive status and detect dementia in patients with cognitive impairment.
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Affiliation(s)
- Li-Yang Liu
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Yi Xing
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Zi-Heng Zhang
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Qing-Ge Zhang
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Ming Dong
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Longjun Cai
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Xiaoyi Wang
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Yi Tang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
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Weziak-Bialowolska D, Bialowolski P, Sacco PL. Mind-stimulating leisure activities: Prospective associations with health, wellbeing, and longevity. Front Public Health 2023; 11:1117822. [PMID: 36875413 PMCID: PMC9982162 DOI: 10.3389/fpubh.2023.1117822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/20/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction This study examines prospective associations within a 6-year perspective between three mind-stimulating leisure activities (relaxed and solitary: reading; serious and solitary: doing number and word games; serious and social: playing cards and games) and 21 outcomes in (1) physical health, (2) wellbeing, (3) daily life functioning, (4) cognitive impairment, and (5) longevity domains. Methods Data were obtained from 19,821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Temporal associations were obtained using generalized estimating equations. All models were controlled for prior sociodemographic, personality, lifestyle factors, health behaviors, and pre-baseline leisure activity values and all outcome variables. The Bonferroni correction was used to correct for multiple testing. E-values were calculated to examine the sensitivity of the associations to unmeasured confounding. Secondary analyses (1) under the complete case scenario, (2) after excluding respondents with health conditions, and (3) using a limited set of covariates were conducted to provide evidence for the robustness of the results. Results The relaxed solitary activity of reading almost daily was prospectively associated with a lower risk of depression, experiencing pain, daily functioning limitations, cognitive impairment, lower loneliness scores, and more favorable wellbeing outcomes. Engaging in serious solitary leisure activities almost daily was prospectively associated with a lower risk of depression, feeling full of energy, and a lower risk of death by any cause. Occasionally engaging in these activities was prospectively associated with greater optimism and a lower risk of cognitive impairment. Engaging in serious social activities was prospectively associated with greater happiness, lower scores on the loneliness scale, a lower risk of Alzheimer's disease, and an increased risk of cancer. Additionally, occasionally engaging in serious social activities was associated with greater optimism and lower risk of depression, pain, and mobility limitations. These associations were independent of demographics, socioeconomic status, personality, history of diseases, and prior lifestyle. The sensitivity analyses provided substantial evidence for the robustness of these associations. Discussion Mind-engaging leisure activities can be considered a health and wellbeing resource. Practitioners may consider them tools that help middle-aged and older adults maintain their health and quality of life.
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Affiliation(s)
- Dorota Weziak-Bialowolska
- Centre for Evaluation and Analysis of Public Policies, Faculty of Philosophy, Jagiellonian University, Cracow, Poland.,Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
| | - Piotr Bialowolski
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States.,Department of Economics, Kozminski University, Warsaw, Poland
| | - Pier Luigi Sacco
- Dipartimento di Scienze Filosofiche, Pedagogiche ed Economico-Quantitative, University of Chieti-Pescara, Pescara, Italy.,metaLAB (at) Harvard, Harvard University, Cambridge, MA, United States.,Consiglio Nazionale delle Ricerche - L'Istituto di Scienze del Patrimonio Culturale, Naples, Italy
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Kumagai R, Osaki T, Oki Y, Murata S, Uchida K, Encho H, Ono R, Kowa H. The Japan-Multimodal Intervention Trial for Prevention of Dementia PRIME Tamba (J-MINT PRIME Tamba): Study protocol of a randomised controlled multi-domain intervention trial. Arch Gerontol Geriatr 2023; 104:104803. [PMID: 36088747 DOI: 10.1016/j.archger.2022.104803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 02/07/2023]
Abstract
The Japan-Multimodal Intervention Trial for Prevention of Dementia PRIME Tamba (J-MINT PRIME Tamba) is a randomised controlled trial to prevent cognitive decline in community-dwelling cognitively ordinary older people at risk of dementia. Participants are aged 65-85 years living in a rural area in Japan, aware of very mild decline in cognitive function or abilities of activities of daily living, have at least one vascular risk (e.g. hypertension or diabetes), and have a Mini-Mental State Examination score of 24 or higher. Approximately 200 participants are randomly divided into two groups, with the intervention group receiving a multi-modal intervention, including lifestyle-related disease management, physical exercise, cognitive training, and nutritional counselling, over 18 months. The primary outcome is change in the composite score of seven neuropsychological tests, including the Free and Cued Selective Reminding Test, Logical Memory I and II subsets of the Wechsler Memory Scale-Revised, and Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale. In addition, changes in a wide range of other parameters such as physical function, blood test results, sleep, and frailty are also analysed as secondary outcomes. We believe that this study's results will contribute significantly to the development of dementia prevention measures in Japan. Clinical trial registration number: UMIN000041938.
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Affiliation(s)
- Ryoko Kumagai
- Division of Cognitive and Psychiatric Rehabilitation, Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
| | - Tohmi Osaki
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe, Hyogo 651-2180, Japan.
| | - Yutaro Oki
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
| | - Shunsuke Murata
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibeshimmachi, Suita, Osaka 564-8565, Japan
| | - Kazuaki Uchida
- Division of Community Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Haruhi Encho
- Division of Community Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
| | - Rei Ono
- Division of Community Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1, Toyama, Shinjyuku, Tokyo 162-8636, Japan
| | - Hisatomo Kowa
- Division of Cognitive and Psychiatric Rehabilitation, Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan.
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Shah AR, Ni L, Bay AA, Hart AR, Perkins MM, Hackney ME. Psychosocial Effects of Remote Reading with Telephone Support versus In-Person Health Education for Diverse, Older Adults. J Appl Gerontol 2023; 42:59-66. [PMID: 36112820 PMCID: PMC9475377 DOI: 10.1177/07334648221127014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This study evaluated initial information about psychosocial differences of 130 diverse, older adults (M age: 70.8 ± 9.2 years) who received a "low-tech" remote (independent reading with telephone support) or in-person education through DREAMS (Developing a Research Participation Enhancement and Advocacy Training Program for Diverse Seniors) health seminar series. Outcomes on measures of depression, quality of life, and spatial extent of lifestyle of 115 completers were analyzed at baseline, immediately post-intervention, and 8-week follow-up. Adjusted at baseline, psychosocial outcomes were compared between groups at post-test and 8-week follow-up using adjusted mean differences. Post-participation, compared to remote participants, in-person participants had significantly lower depression on Beck Depression Inventory-II, Geriatric Depression Scale, and significantly higher mental quality of life on Short Form-12. This study links knowledge acquisition via in-person learning with decreased stress, depression, and increased quality of life among seniors. Identifying effective educational delivery methods may increase clinical research involvement for aging communities.
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Affiliation(s)
- Anjali R. Shah
- Rollins School of Public Health, Emory University, Atlanta, GA, USA,College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Liang Ni
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Allison A. Bay
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Ariel R. Hart
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Molly M. Perkins
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA,Emory University School of Nursing, Atlanta, GA, USA,Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Birmingham, AL, USA,Deparment of Sociology, Emory University, Atlanta, GA, USA
| | - Madeleine E. Hackney
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA,Emory University School of Nursing, Atlanta, GA, USA,Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Birmingham, AL, USA,Atlanta VA Center for Visual & Neurocognitive Rehabilitation, Decatur, GA, USA,Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA,Madeleine E. Hackney, Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta VA Health Care System, 1841 Clifton Road NE, #553, Atlanta, GA 30324, USA. ,
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Clark AL, Weigand AJ, Clay OJ, Owens J, Fiala J, Crowe M, Marsiske M, Thomas KR. Associations between social determinants of health and 10-year change in everyday functioning within Black/African American and White older adults enrolled in ACTIVE. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12385. [PMID: 36514539 PMCID: PMC9732812 DOI: 10.1002/dad2.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/31/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
Introduction Given prior work showing racial differences on baseline social determinants of health (SDoH) and 10-year trajectories of everyday functioning, we examined associations between SDoH and longitudinal everyday functioning performance in Black/African American and White older adults. Methods Participants were 2505 older adults (Mage = 73.5; 28% Black/African American) without dementia. SDoH included economic stability/status, education access/quality, health-care access, neighborhood/built environment, and social/community contexts. The Observed Tasks of Daily Living (OTDL) measured everyday functioning and was administered at baseline and 1-, 2-, 3-, 5-, and 10-year visits. Results Across the sample, social and community context and economic stability/status were associated with steeper age-related OTDL declines (βs = 0.05 to 0.07, Ps < 0.001). Lower levels of social and community context (β = 0.08, P = 0.002) and economic stability/status (β = 0.07, P = 0.04) were associated with OTDL linear age declines in Black/African American participants, but not in White participants (Ps > 0.30). Discussion Inequities across SDoH accelerate age-related declines in everyday functioning among Black/African American older adults.
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Affiliation(s)
- Alexandra L. Clark
- Department of PsychologyCollege of Liberal ArtsUniversity of Texas at AustinAustinTexasUSA
| | - Alexandra J. Weigand
- Department of PsychiatrySchool of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Olivio J. Clay
- Department of Psychology, College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Joshua Owens
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Jacob Fiala
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Michael Crowe
- Department of Psychology, College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Kelsey R. Thomas
- Department of PsychiatrySchool of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA,Research Services, VA San Diego Healthcare System (VASDHS)San DiegoCaliforniaUSA
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Juras L, Martincević M, Vranić A, Rebernjak B, Hromatko I. The brief case for everyday problems: a proposal of two brief alternate forms of the Everyday Problems Test. Eur J Ageing 2022; 19:1519-1528. [PMID: 36692781 PMCID: PMC9729654 DOI: 10.1007/s10433-022-00734-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 01/26/2023] Open
Abstract
Everyday Problems Test (EPT; Willis and Marsiske, Manual for the everyday problems test, Pennsylvania State University, Pennsylvania, 1993) is an 84-item performance-based measure of older adults' everyday cognitive competencies in seven everyday domains (e.g., finance, reading prescription). Its length makes it disadvantageous in the typical time-constrained testing context. Due to the potential practice effects, it is also impractical for longitudinal and intervention studies which require repetitive testing. We have addressed these issues by adapting two brief forms of EPT, with 14 items each. The psychometric evaluation of these two versions was conducted on a sample of 157 cognitively healthy older adults. Both brief forms demonstrated good internal consistency, high inter-correlation, and have shown satisfactory concurrent criterion-related validity based on their correlations with socio-demographic and cognitive variables. Results indicate that the two proposed brief forms can be a valuable tool in assessing the everyday cognitive competence of healthy older adults either as a one-time screening instrument or as a pretest-posttest difference indicator of the intervention efficacy.
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Affiliation(s)
- Luka Juras
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Marina Martincević
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Andrea Vranić
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Blaž Rebernjak
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
| | - Ivana Hromatko
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia
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Coley N, Giulioli C, Aisen PS, Vellas B, Andrieu S. Randomised controlled trials for the prevention of cognitive decline or dementia: A systematic review. Ageing Res Rev 2022; 82:101777. [PMID: 36336171 DOI: 10.1016/j.arr.2022.101777] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/02/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
Dementia prevention research has progressed rapidly in recent years, with publication of several large lifestyle intervention trials, and renewed interest in pharmacological interventions, notably for individuals with Alzheimer's disease biomarkers, warranting an updated review of results and methodology. We identified 112 completed trials testing the efficacy of single-domain pharmacological (n = 33, 29%), nutritional (n = 27, 24%), physical activity (n = 18, 16%) and cognitive stimulation (n = 13, 12%), or multidomain (n = 22, 20%) interventions on incident dementia, or a relevant intermediate marker (e.g. cognitive function, biomarkers or dementia risk scores) in people without dementia. The earliest trials tested pharmacological interventions or nutritional supplements, but lifestyle interventions predominated in the last decade. In total, 21 (19%) trials demonstrated a clear beneficial effect on the pre-specified primary outcome (or all co-primary outcomes), but only two (10%) were large-scale (testing blood pressure lowering (Syst-Eur) or multidomain (FINGER) interventions on incident dementia and cognitive change in cognitive function, respectively). Of the 116 ongoing trials, 40% (n = 46) are testing multidomain interventions. Recent methodological shifts concern target populations, primary outcome measures, and intervention design, but study design remains constant (parallel group randomised controlled trial). Future trials may consider using adaptive trials or interventions, and more targeted approaches, since certain interventions may be more effective in certain subgroups of the population, and at specific times in the life-course. Efforts should also be made to increase the representativeness and diversity of prevention trial populations.
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Affiliation(s)
- Nicola Coley
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France.
| | - Caroline Giulioli
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Bruno Vellas
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital, France
| | - Sandrine Andrieu
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
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Belleville S, Cloutier S, Mellah S, Willis S, Vellas B, Andrieu S, Coley N, Ngandu T. Is more always better? Dose effect in a multidomain intervention in older adults at risk of dementia. Alzheimers Dement 2022; 18:2140-2150. [PMID: 35049127 PMCID: PMC9786573 DOI: 10.1002/alz.12544] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/08/2021] [Accepted: 10/25/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Little is known regarding the dose-response function in multidomain interventions for dementia prevention. METHOD The Multidomain Alzheimer Preventive Trial is a 3-year randomized controlled trial comprising cognitive training, physical activity, nutrition, and omega-3 polyunsaturated fatty acids for at-risk older adults. The dose delivered (number of sessions attended) was modeled against global cognition, memory, and fluency in 749 participants. Interaction effects were assessed for age, sex, education, dementia score (CAIDE), frailty score, and apolipoprotein E (APOE) ε4 status. RESULTS The dose-response models were non-linear functions indicating benefits up to about 12 to 14 training hours or 15 to 20 multidomain sessions followed by a plateau. Participants who benefited from a higher dose included women, younger participants, frail individuals, and those with lower education or lower risk of dementia. DISCUSSION The non-linear function indicates that a higher dose is not necessarily better in multidomain interventions. The optimal dose was about half of the potentially available sessions.
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Affiliation(s)
- Sylvie Belleville
- Research CenterInstitut Universitaire de gériatrie de MontréalMontrealQuebecCanada,Psychology departmentFaculty of Arts and ScienceUniversité de MontréalMontrealCanada
| | - Simon Cloutier
- Research CenterInstitut Universitaire de gériatrie de MontréalMontrealQuebecCanada,Psychology departmentFaculty of Arts and ScienceUniversité de MontréalMontrealCanada
| | - Samira Mellah
- Research CenterInstitut Universitaire de gériatrie de MontréalMontrealQuebecCanada
| | - Sherry Willis
- Department of PsychiatryUniversity of WashingtonSeattleWashingtonUSA
| | - Bruno Vellas
- Gérontopôle de Toulouse, CHU de ToulouseToulouseFrance,Center for Epidemiology and Research in Population health (CERPOP)University of ToulouseToulouseFrance,INSERM UMR1295UPSToulouseFrance
| | - Sandrine Andrieu
- Center for Epidemiology and Research in Population health (CERPOP)University of ToulouseToulouseFrance,INSERM UMR1295UPSToulouseFrance,Department of Clinical Epidemiology and Public HealthToulouse University HospitalToulouseFrance
| | - Nicola Coley
- Center for Epidemiology and Research in Population health (CERPOP)University of ToulouseToulouseFrance,INSERM UMR1295UPSToulouseFrance,Department of Clinical Epidemiology and Public HealthToulouse University HospitalToulouseFrance
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL)HelsinkiFinland
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Li X, Xia J, Li Y, Xu K, Chen K, Zhang J, Li H, Zhang Z. Risk scores of incident mild cognitive impairment in a Beijing community-based older cohort. Front Aging Neurosci 2022; 14:976126. [PMID: 36262884 PMCID: PMC9574183 DOI: 10.3389/fnagi.2022.976126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: It is very important to identify individuals who are at greatest risk for mild cognitive impairment (MCI) to potentially mitigate or minimize risk factors early in its course. We created a practical MCI risk scoring system and provided individualized estimates of MCI risk. Methods: Using data from 9,000 older adults recruited for the Beijing Ageing Brain Rejuvenation Initiative, we investigated the association of the baseline demographic, medical history, lifestyle and cognitive data with MCI status based on logistic modeling and established risk score (RS) models 1 and 2 for MCI. We evaluated model performance by computing the area under the receiver operating characteristic (ROC) curve (AUC). Finally, RS model 3 was further confirmed and improved based on longitudinal outcome data from the progression of MCI in a sub-cohort who had an average 3-year follow-up. Results: A total of 1,174 subjects (19.8%) were diagnosed with MCI at baseline, and 72 (7.8%) of 849 developed MCI in the follow-up. The AUC values of RS models 1 and 2 were between 0.64 and 0.70 based on baseline age, education, cerebrovascular disease, intelligence and physical activities. Adding baseline memory and language performance, the AUC of RS model 3 more accurately predicted MCI conversion (AUC = 0.785). Conclusion: A combination of risk factors is predictive of the likelihood of MCI. Identifying the RSs may be useful to clinicians as they evaluate their patients and to researchers as they design trials to study possible early non-pharmaceutical interventions to reduce the risk of MCI and dementia.
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Affiliation(s)
- Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Jianan Xia
- BABRI Centre, Beijing Normal University, Beijing, China
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Yumeng Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Kai Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Kewei Chen
- BABRI Centre, Beijing Normal University, Beijing, China
- Banner Alzheimer’s Institute, Phoenix, AZ, United States
| | - Junying Zhang
- BABRI Centre, Beijing Normal University, Beijing, China
- Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, China
| | - He Li
- BABRI Centre, Beijing Normal University, Beijing, China
- Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
- *Correspondence: Zhanjun Zhang
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