1
|
Montejo Carrasco P, Montenegro-Peña M, Prada Crespo D, Rodríguez Rojo I, Barabash Bustelo A, Montejo Rubio B, Marcos Dolado A, Maestú Unturbe F, Delgado Losada ML. APOE genotype, hippocampal volume, and cognitive reserve predict improvement by cognitive training in older adults without dementia: a randomized controlled trial. Cogn Process 2024:10.1007/s10339-024-01202-3. [PMID: 38896211 DOI: 10.1007/s10339-024-01202-3] [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: 08/01/2023] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
Cognitive training (CT) programs aim to improve cognitive performance and impede its decline. Thus, defining the characteristics of individuals who can benefit from these interventions is essential. Our objectives were to assess if the cognitive reserve (CR), APOE genotype (e4 carriers/non-carriers) and/or hippocampal volume might predict the effectiveness of a CT program. Participants were older adults without dementia (n = 226), randomized into parallel experimental and control groups. The assessment consisted of a neuropsychological protocol and additional data regarding total intracranial, gray matter, left/right hippocampus volume; APOE genotype; and Cognitive Reserve (CR). The intervention involved multifactorial CT (30 sessions, 90 min each), with an evaluation pre- and post-training (at six months); the control group simply following the center's routine activities. The primary outcome measures were the change in cognitive performance and the predictors of change. The results show that APOE-e4 non-carriers (79.1%) with a larger left hippocampal volume achieved better gains in semantic verbal fluency (R2 = .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R2 = .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R2 = .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R2 = .087). In conclusion, besides the program itself, the effectiveness of CT depends on age, biological factors like genotype and brain volume, and CR. Thus, to achieve better results through a CT, it is essential to consider the different characteristics of the participants, including genetic factors.Trial registration: Trial retrospectively registered on January 29th, 2020-(ClinicalTrials.gov -NCT04245579).
Collapse
Affiliation(s)
- Pedro Montejo Carrasco
- Centre for the Prevention of Cognitive Impairment, Madrid Salud, Madrid City Council, Montesa 22 Building B, 28006, Madrid, Spain
| | - Mercedes Montenegro-Peña
- Centre for the Prevention of Cognitive Impairment, Madrid Salud, Madrid City Council, Montesa 22 Building B, 28006, Madrid, Spain.
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain.
| | - David Prada Crespo
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain
- Department of Psychology, Faculty of Biomedical and Health Sciences, European University, Madrid, Spain
| | - Inmaculada Rodríguez Rojo
- Center for Cognitive and Computational Neuroscience, Complutense University, Madrid, Spain
- Department of Nursing and Physiotherapy, Alcalá University, Madrid, Spain
| | - Ana Barabash Bustelo
- Endocrinology and Nutrition Department, San Carlos Clinic Hospital, Health Research Institute of the San Carlos Clinic Hospital (IdISSC), Madrid, Spain
- Department of Medicine II, Faculty of Medicine, Complutense University, Madrid, Spain
| | | | - Alberto Marcos Dolado
- Department of Neurology, San Carlos Clinic Hospital, Health Research Institute of the San Carlos Clinic Hospital (IdISSC), Madrid, Spain
| | - Fernando Maestú Unturbe
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University, Madrid, Spain
| | | |
Collapse
|
2
|
Gómez-Soria I, Ferreira C, Oliván-Blázquez B, Aguilar-Latorre A, Calatayud E. Effects of cognitive stimulation program on cognition and mood in older adults, stratified by cognitive levels: A randomized controlled trial. Arch Gerontol Geriatr 2023; 110:104984. [PMID: 36921506 DOI: 10.1016/j.archger.2023.104984] [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: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE OF THE RESEARCH Cognitive stimulation (CS) is defined as activities that involve cognitive processing, usually conducted in a social context and often in a group. This study aims to evaluate the effects of a personalized-adapted CS program in older adults on global cognition, neuropsychological constructs, activities of daily living (ADLs), and mood. MATERIALS AND METHODS The randomized controlled single-blind trial involving 337 participants (235 women and 102 men) ≥ 65 years of age in a Primary Care centre classified participants into 4 groups: 101 for the no deterioration (ND) group; 100 for the subjective cognitive impairment (SCI) group; 108 for the level deterioration (LD) group and 28 for the moderate deterioration group. The intervention consisted of a personalized CS adapted program for 10 weeks. Follow-up assessments were conducted post-intervention, and at 6 and 12 months. The primary outcome was global cognition measured by the Spanish version of the Mini-Mental State Examination. The secondary outcomes were measured by the Barthel Index, the Lawton and Brody Scale, the Goldberg Questionnaire (anxiety sub-scale) and the abbreviated Yesavage Geriatric Depression Scale. RESULTS The intervention showed a tendency of improvement on global cognition and different cognitive functions for groups with no deterioration or level deterioration. The group with moderate deterioration improved in anxiety. CONCLUSIONS The findings demonstrated benefits in global cognition, different cognitive functions, semantic fluency, IADLs and anxiety. The most benefits are given in the intermediate groups, SCI, and LD. Moreover, the intervention works by increasing the benefits in the different phases.
Collapse
Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda. San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Chelo Ferreira
- Department of Applied Mathematics and IUMA, Faculty of Veterinary Sciences, University of Zaragoza, 50013 Zaragoza, Spain.
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda. San Juan Bosco, 13, 50009 Zaragoza, Spain; Department of Psychology and Sociology, Faculty of Social and Labor Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda. San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda. San Juan Bosco, 13, 50009 Zaragoza, Spain
| |
Collapse
|
3
|
Gómez-Soria I, Iguacel I, Aguilar-Latorre A, Peralta-Marrupe P, Latorre E, Zaldívar JNC, Calatayud E. Cognitive stimulation and cognitive results in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 104:104807. [PMID: 36116285 DOI: 10.1016/j.archger.2022.104807] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE The lack of cognitive activity accelerates age cognitive decline. Cognitive stimulation (CS) tries to enhance cognitive functioning. The purpose of this systematic review and meta-analysis was to evaluate the effects of CS on cognitive outcomes (general cognitive functioning and specific cognitive domains) in older adults (aged 65 years or older, cognitively healthy participants, or with mild cognitive impairment, or dementia). METHODS PubMed, Scopus and Web of Science databases were examined from inception to October 2021. A total of 1,997 studies were identified in these databases, and. 33 studies were finally included in the systematic review and the meta-analysis. Raw means and standard deviations were used for continuous outcomes. Publication bias was examined by Egger's Regression Test for Funnel Plot Asymmetry and the quality assessment tools from the National Institutes of Health. RESULTS CS significantly improves general cognitive functioning (mean difference=MD = 1.536, 95%CI, 0.832 to 2.240), memory (MD = 0.365, 95%CI, 0.300 to 0.430), orientation (MD = 0.428, 95%CI, 0.306 to 0.550), praxis (MD = 0.278, 95%CI, 0.094 to 0.462) and calculation (MD = 0.228, 95%CI, 0.112 to 0.343). CONCLUSION CS seems to increase general cognitive functioning, memory, orientation, praxis, and calculation in older adults.
Collapse
Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.
| | - Isabel Iguacel
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain.
| | | | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Eva Latorre
- Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan Nicolás Cuenca Zaldívar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain; Primary Health Center "El Abajon", 28231 Las Rozas de Madrid, Spain
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| |
Collapse
|
4
|
Gómez-Soria I, Brandín-de la Cruz N, Cuenca Zaldívar JN, Calvo S, Herrero P, Calatayud E. Effectiveness of Personalized Cognitive Stimulation in Older Adults with Mild Possible Cognitive Impairment: A 12-month Follow-up Cognitive Stimulation in Mild Cognitive Impairment. Clin Gerontol 2022; 45:878-890. [PMID: 34128780 DOI: 10.1080/07317115.2021.1937764] [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: 10/21/2022]
Abstract
OBJECTIVE The objective of this study was to analyze the long-term effects of a personalized cognitive stimulation (PCS) program on the global cognition, cognitive aspects, activities of daily living (ADLs), anxiety, and depression in older adults with possible mild cognitive impairment (MCI). METHODS A 12-month follow-up analysis was carried out in a single-blind, randomized clinical trial to research the long-term effects of a 10-week PCS program evaluating the cognitive level, depression, and anxiety of older adults with possible MCI. RESULTS Fifty older adults were assessed 12 months after the CS program, 23 in the intervention group and 27 in the control group. There were significant differences between the groups at 12 months in the global cognition (p = .002), in global orientation (p < .001), and in spatial orientation (p = .004) in favor of the intervention group, measured with the Spanish version of the Mini-Mental Status Examination (MEC-35). CONCLUSIONS A PCS program could be effective in improving global cognition and global and spatial orientation. CLINICAL IMPLICATIONS A PCS program based on cognitive levels in older adults with possible MCI achieves improvements in global cognition and global and spatial orientation. PCS programs can be applied successfully by trained occupational therapists.
Collapse
Affiliation(s)
- Isabel Gómez-Soria
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | | | | | - Sandra Calvo
- iPhysio Research Group, Universidad San Jorge, Zaragoza, Spain
| | - Pablo Herrero
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Estela Calatayud
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| |
Collapse
|
5
|
Gómez-Soria I, Andrés Esteban EM, Gómez Bruton A, Peralta-Marrupe P. [Long-term effect analysis of a cognitive stimulation program in mild cognitive impairment elderly in Primary Care: A randomized controlled trial]. Aten Primaria 2021; 53:102053. [PMID: 33865010 PMCID: PMC8066353 DOI: 10.1016/j.aprim.2021.102053] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To provide evidence about the efficacy of a community health intervention through a cognitive stimulation program at long term in older people with mild cognitive impairment. DESIGN Randomized controlled trial (CONSORT group norms). LOCATION San José Norte-Centro Primary Care Center and La Caridad Foundation (Zaragoza, Spain). PARTICIPANTS Twenty-nine people over 65 years old with a 24-27 MEC score that completed 48 months follow up. They were randomized between the intervention group (15) and the control group (14). INTERVENTIONS The intervention was applied in 10 sessions of 45min for 10 weeks using the red notebook tool for mental activation that works memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention and executive functions. MAIN MEASUREMENTS The main outcome variables were MEC-35, Set-test, Barthel index, Lawton-Brody scale, Goldberg anxiety scale and Yesavage geriatric depression scale short form. RESULTS Increases of the main result variable over the baseline level of MEC-35 were analyzed. On average, the intervention group obtained higher scores than control: 3.14 points post intervention, 3.76 points after 6 months and 2.26 points more than control group after 12 months. All the differences were statistically significant. After 48 months the intervention group obtained 2 points more than control group. The intervention did not improve verbal fluency, activity daily living and mood. CONCLUSIONS Our cognitive stimulation program seems to improve cognitive performance, measured with the variable MEC-35 at post intervention, 6, 12 and 48 months. There is no evidence of improvement in verbal fluency, activity daily livings and mood. Clinicaltrials.gov Identifier: NCT03831061.
Collapse
Affiliation(s)
- Isabel Gómez-Soria
- Fundación La Caridad, Zaragoza, España; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| | - Eva María Andrés Esteban
- Grupo «Manejo del paciente sangrante» - IDIPaz (Hospital Universitario La Paz - Madrid). Universidad Rey Juan Carlos, Madrid, España
| | - Alejandro Gómez Bruton
- GENUD (Growth, Exercise, Nutrition and Development Research group), Departamento de Fisiatría y Enfermería, Área de Educación Física y Deportiva; Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Huesca, España
| | | |
Collapse
|
6
|
Roheger M, Liebermann-Jordanidis H, Krohm F, Adams A, Kalbe E. Prognostic Factors and Models for Changes in Cognitive Performance After Multi-Domain Cognitive Training in Healthy Older Adults: A Systematic Review. Front Hum Neurosci 2021; 15:636355. [PMID: 33986652 PMCID: PMC8110835 DOI: 10.3389/fnhum.2021.636355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/26/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Cognitive Training (CT) may contribute to the maintenance and even enhancement of cognitive functions in healthy older adults. However, the question who benefits most from multi-domain CTs is still highly under-investigated. Objective: The goal is to investigate prognostic factors and models for changes in cognitive test performance in healthy older adults after a multi-domain CT. Methods: The data bases MEDLINE, Web of Science Core Collection, CENTRAL, and PsycInfo were searched up to July 2019. Studies investigating prognostic factors and/or models on cognitive outcomes (global cognition, memory, attention, executive functions, language, visuo-spatial abilities) after conducting a multi-domain CT in healthy older adults were included. Risk of Bias was assessed using the QUIPS and the PROBAST tool. Results: 23 prognostic factor and model studies were included. Results indicate a high heterogeneity regarding the conducted multi-domain CTs, the investigated prognostic factors, the investigated outcomes, and the used statistical approaches. Age and neuropsychological performance at study entry were the most investigated predictors, yet they show inconsistent results. Conclusion: Data on prognostic factors and models of changes after multi-domain CT are still too rare and inconsistent to draw clear conclusions due to statistical shortcomings and low reporting quality. Approaches for future research are outlined. Registration:https://www.crd.york.ac.uk/prospero/, ID: CRD42020147531
Collapse
Affiliation(s)
- Mandy Roheger
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany.,Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Hannah Liebermann-Jordanidis
- Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Fabian Krohm
- Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| |
Collapse
|
7
|
Lyu Q, Cheung DSK, Lai H, Wang X, Qiu J, Huang Y, Zeng Y. A multicomponent integrative intervention to slow down the progression of mild cognitive impairment: A protocol for a randomized controlled trial. Res Nurs Health 2020; 43:307-316. [PMID: 32627231 DOI: 10.1002/nur.22050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/22/2020] [Accepted: 06/24/2020] [Indexed: 12/19/2022]
Abstract
Mild cognitive impairment affects 36% of people aged 65 years and over in China, and around 50% transition from mild cognitive impairment to dementia within 3 years. Early intervention can slow down disease progression and thus delay dementia onset. The purpose of this article is to outline the protocol of an ongoing randomized controlled trial in mainland China that will evaluate the effects and feasibility of a 6-month multicomponent integrative intervention on the speed of progression of mild cognitive impairment to dementia. Ninety-six community-dwelling older adults, aged 65 years and older, will be recruited (recruitment will be completed in May 2020), using strict inclusion/exclusion criteria, from two community health service centers in Guangzhou, Guangdong province. Participants will be allocated to receive either the multicomponent integrative intervention or usual care. The core components of the intervention are cognitive training, dietary instruction, physical activity, and management of vascular risk factors. Data are collected at the beginning of the study, then at 1, 3, and 6 months. The primary outcome is cognitive function. The main secondary outcomes are exercise capacity, comprehensive physical capacity, depression, and quality of life. An intention-to-treat analysis will be conducted. The study will be completed in 2021. The multicomponent integrative intervention detailed in this protocol could be incorporated into dementia prevention programs in community health service centers, or other similar settings, to delay the onset of dementia.
Collapse
Affiliation(s)
- Qiyuan Lyu
- School of Nursing, Jinan University, Guangzhou, China
| | - Daphne S K Cheung
- School of Nursing, The Hong Kong Polytechnic University, Guangzhou, China
| | - Huilan Lai
- Department of Nursing, People's Street Community Health Service Center, Guangzhou, China
| | - Xiaomeng Wang
- Department of Nursing, People's Street Community Health Service Center, Guangzhou, China
| | - Jing Qiu
- Department of Nursing, People's Street Community Health Service Center, Guangzhou, China
| | - Yuanqiu Huang
- Department of Nursing, People's Street Community Health Service Center, Guangzhou, China
| | - Yingchun Zeng
- Research Institute of Gynecology and Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
8
|
Sherman DS, Durbin KA, Ross DM. Meta-Analysis of Memory-Focused Training and Multidomain Interventions in Mild Cognitive Impairment. J Alzheimers Dis 2020; 76:399-421. [PMID: 32508325 DOI: 10.3233/jad-200261] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Meta-analysis examining the efficacy of cognitive interventions on neuropsychological outcomes have suggested interventions that focus on memory may actually provide greater benefit against the cognitive declines associated with mild cognitive impairment (MCI). However, it remains unclear if memory-based training would be more effective at addressing the cognitive deficits associated with MCI than multidomain forms of intervention. OBJECTIVE A meta-analytic review and subgroup analysis was conducted to examine the effects of cognitive training in individuals diagnosed with MCI and to compare the efficacy of memory-based training with multidomain interventions. METHODS A total of 32 randomized controlled trials met inclusion criteria for the meta-analysis, which included 9 studies on memory-focused training and 17 studies on multidomain interventions. RESULTS We found significant, large effects for memory-focused training (Hedges' g observed = 0.947; 95% CI [-1.668, 3.562]; Z = 2.517; p = 0.012) and significant, moderate effects for multidomain interventions (Hedges' g observed = 0.420; 95% CI [-0.4491, 1.2891]; Z = 3.525; p < 0.001). A subgroup analysis found significant point estimates for memory-based forms of training and multidomain interventions, with memory-based forms of content yielding significantly greater summary effects than multidomain interventions (SMD Z = 2.162; p = 0.031, two-tailed; all outcomes). There was no difference between effect sizes when comparing outcomes limited to its respective domain. CONCLUSION Overall, these findings suggest that, while both interventions were beneficial, treatment interventions that were strictly memory-based were more effective at improving cognition in individuals diagnosed with MCI than interventions that targeted multiple cognitive domains.
Collapse
Affiliation(s)
- Dale S Sherman
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Rossier School of Education, University of Southern California, Los Angeles, CA, USA
| | - Kelly A Durbin
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - David M Ross
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, Loma Linda University, Loma Linda, CA, USA
| |
Collapse
|
9
|
Gomez-Soria I, Peralta-Marrupe P, Plo F. Cognitive stimulation program in mild cognitive impairment A randomized controlled trial. Dement Neuropsychol 2020; 14:110-117. [PMID: 32595879 PMCID: PMC7304274 DOI: 10.1590/1980-57642020dn14-020003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Non-pharmacological cognitive interventions in mild cognitive impairment have demonstrated promising results in preventing or delaying cognitive impairment and functional disability. Cognitive stimulation seems to improve and maintain cognitive and social activity.
Collapse
Affiliation(s)
- Isabel Gomez-Soria
- University of Zaragoza Ringgold standard institution Zaragoza, Aragón, Spain
| | - Patricia Peralta-Marrupe
- Royal Devon and Exeter Hospital Ringgold standard institution Barrack Road, Exeter EX2 5DW United Kingdom of Great Britain and Northern Ireland
| | - Fernando Plo
- University of Zaragoza Ringgold standard institution Zaragoza, Aragón, Spain
| |
Collapse
|
10
|
Bråthen ACS, De Lange AMG, Fjell AM, Walhovd KB. Risk- and protective factors for memory plasticity in aging. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:201-217. [PMID: 32098566 DOI: 10.1080/13825585.2020.1727834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Risk and protective factors for cognitive function in aging may affect how much individuals benefit from their environment or life experiences by preserving or improving cognitive abilities. We investigated the relations between such factors and outcome from episodic-memory training in 136 healthy young and older adults. Tested risk factors included carrying the ɛ4 variant of the apolipoprotein E allele (APOE), age, body mass index, blood pressure, and cholesterol. Protective factors included higher levels of education, intelligence quotient (IQ), physical activity, fatty acids, and vitamin D. Average increases in memory performance were seen after training, with ample variation between individuals. Being young, female, and having higher IQ were positive predictors of memory improvement. No other relationships were observed. Similar benefit was observed across APOE allelic variation. This indicates that beyond IQ, age, and sex, known risk -and protective factors of cognitive function in aging were not significantly related to memory plasticity.
Collapse
Affiliation(s)
- Anne Cecilie Sjøli Bråthen
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo , Oslo, Norway
| | - Ann-Marie Glasø De Lange
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo , Oslo, Norway
| | - Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo , Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital , Oslo, Norway
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo , Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital , Oslo, Norway
| |
Collapse
|
11
|
Calatayud E, Plo F, Muro C. [Analysis of the effect of a program of cognitive stimulation in elderly people with normal aging in primary care: Randomized clinical trial]. Aten Primaria 2020; 52:38-46. [PMID: 30470457 PMCID: PMC6939008 DOI: 10.1016/j.aprim.2018.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 09/19/2018] [Accepted: 09/25/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To provide evidence of the effectiveness of a community health intervention, that includes a cognitive stimulation program, to prevent the deterioration of cognitive abilities in our population of elderly people with normal cognition that are living in the community. DESIGN Randomized clinical trial (CONSORT group norms) LOCATION: San José Norte-Centro Health Center and La Caridad Foundation (Zaragoza, Spain). PARTICIPANTS 201 people aged 65 or older, with a MEC score of at least 28 points, which were randomized between the Intervention group (101) and the Control group (100). INTERVENTION The intervention was applied in 10 sessions of 45minutes, one per week. It used materials designed by one of the authors, which addressed the following areas: memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention-concentration and programming. MAIN MEASUREMENTS The main outcome variables were MEC, Set-Test, Barthel and Lawton-Brody. RESULTS Increases of the main result variables over their baseline level were analized. For MEC variable, the Intervention group obtained, on average, 1.58 points more than the Control group in the evaluation performed immediately after the intervention. After 6months, the improvement was 1.51 points and after a year, it was of 2.04 points. All these differences were statistically significant. For Set-Test, Barthel and Lawton-Brody variables, no statistically significant differences were observed between Intervention group and Control group. CONCLUSIONS Cognitive stimulation with our program is effective to maintain or improve cognitive performance, measured with the variable MEC, our population of elderly people with normal cognition that are living in the community. There is no evidence that this improvement is transferred to the activities of daily life measured with Barthel and Lawton-Brody variables.
Collapse
Affiliation(s)
- Estela Calatayud
- Centro de día Los Sitios, Fundación La Caridad, Zaragoza, España.
| | - Fernando Plo
- Departamento de Métodos Estadísticos y BIFI, Universidad de Zaragoza, Zaragoza, España
| | - Carmen Muro
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| |
Collapse
|
12
|
Sumirtanurdin R, Thalib AY, Cantona K, Abdulah R. Effect of genetic polymorphisms on Alzheimer's disease treatment outcomes: an update. Clin Interv Aging 2019; 14:631-642. [PMID: 30992661 PMCID: PMC6445219 DOI: 10.2147/cia.s200109] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Genetic variations in individuals may cause differences in the response to cholinesterase inhibitor drugs used in the treatment of Alzheimer's disease (AD). Through this review, we aimed to understand the potential relationship between genetic polymorphisms and treatment response in AD. We conducted a systematic review of the studies published from 2006 to 2018 that assessed the relationship between genetic polymorphisms and the pharmacotherapeutic outcomes of patients with AD. Via several possible mechanisms, genetic polymorphisms of many genes, including ABCA1, ApoE3, CYP2D6, CHAT, CHRNA7, and ESR1, appear to have strong correlations with the treatment response of patients with AD. Indeed, these genetic polymorphisms, either in the form of single nucleotide polymorphisms or direct changes to one or more amino acids, have been shown to cause differences in the therapeutic response. In summary, our findings indicate that genetic polymorphisms should be considered in the management of AD to achieve both effective and efficient treatment outcomes in terms of cost and prognosis.
Collapse
Affiliation(s)
- Riyadi Sumirtanurdin
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia,
| | - Amirah Y Thalib
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia,
| | - Kelvin Cantona
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia,
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia, .,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia,
| |
Collapse
|
13
|
López-Higes R, Rodríguez-Rojo IC, Prados JM, Montejo P, Del-Río D, Delgado-Losada ML, Montenegro M, López-Sanz D, Barabash A. APOE ε4 Modulation of Training Outcomes in Several Cognitive Domains in a Sample of Cognitively Intact Older Adults. J Alzheimers Dis 2018; 58:1201-1215. [PMID: 28550244 DOI: 10.3233/jad-161014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Most research points to the ɛ4 allele of the apolipoprotein E (APOE) gene as the most recognizable genetic risk factor associated with Alzheimer's disease pathogenesis. It has been also suggested that the APOEɛ4 allele has a negative influence on cognitive functioning, which begins long before cognitive impairment becomes manifest. However, still, little is known about the APOEɛ4 interaction with cognitive intervention programs. OBJECTIVE The main goal of this study was to explore whether there was a differential APOE genotype modulation effect after cognitive training in different domains, such as language comprehension, executive functions, and memory. Contrary to other studies, hippocampal volume was controlled for. METHODS Fifty older adults (65+ years; 30 women and 20 men) participated in a multi-domain cognitive training that involved 30 sessions taking place over 12 weeks. Half of the participants were APOEɛ4 carriers. The control group was matched in age, gender, normalized hippocampal volume, cognitive reserve, Mini-Mental State Examination score, and Geriatric Depression Scale-Short Version. RESULTS The study revealed that there were consistent treatment benefits in complex sentence comprehension (noncanonical sentences and sentences with two propositions), a domain that was not directly trained, but only in the A POEɛ4 noncarrier group. CONCLUSION Genetic profile modulates training outcomes in sentence comprehension.
Collapse
Affiliation(s)
- Ramón López-Higes
- Department of Cognitive Processes, Complutense University of Madrid, Madrid, Spain
| | - Inmaculada C Rodríguez-Rojo
- Department of Cognitive Processes, Complutense University of Madrid, Madrid, Spain.,Cognitive and Computational Neuroscience Laboratory, Madrid, Spain
| | - José M Prados
- Department of Cognitive Processes, Complutense University of Madrid, Madrid, Spain
| | - Pedro Montejo
- Center for the Prevention of Cognitive Impairment, Madrid-Salud, Madrid, Spain
| | - David Del-Río
- Department of Cognitive Processes, Complutense University of Madrid, Madrid, Spain.,Cognitive and Computational Neuroscience Laboratory, Madrid, Spain
| | | | - Mercedes Montenegro
- Center for the Prevention of Cognitive Impairment, Madrid-Salud, Madrid, Spain
| | - David López-Sanz
- Department of Cognitive Processes, Complutense University of Madrid, Madrid, Spain.,Cognitive and Computational Neuroscience Laboratory, Madrid, Spain
| | - Ana Barabash
- Laboratory of Psychoneuroendocrinology and Genetics, San Carlos Clinical Hospital, Madrid, Spain.,Institute of Sanitary Investigation, San Carlos Clinical Hospital, Madrid, Spain
| |
Collapse
|
14
|
Sherman DS, Mauser J, Nuno M, Sherzai D. The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures. Neuropsychol Rev 2017; 27:440-484. [PMID: 29282641 PMCID: PMC5754430 DOI: 10.1007/s11065-017-9363-3] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/05/2017] [Indexed: 12/12/2022]
Abstract
Cognitive training in MCI may stimulate pre-existing neural reserves or recruit neural circuitry as “compensatory scaffolding” prompting neuroplastic reorganization to meet task demands (Reuter-Lorenz & Park, 2014). However, existing systematic reviews and meta-analytic studies exploring the benefits of cognitive interventions in MCI have been mixed. An updated examination regarding the efficacy of cognitive intervention in MCI is needed given improvements in adherence to MCI diagnostic criteria in subject selection, better defined interventions and strategies applied, increased use of neuropsychological measures pre- and post-intervention, as well as identification of moderator variables which may influence treatment. As such, this meta-analytic review was conducted to examine the efficacy of cognitive intervention in individuals diagnosed with mild cognitive impairment (MCI) versus MCI controls based on performance of neuropsychological outcome measures in randomized controlled trials (RCT). RCT studies published from January 1995 to June 2017 were obtained through source databases of MEDLINE-R, PubMed, Healthstar, Global Health, PSYCH-INFO, and Health and Psychological Instruments using search parameters for MCI diagnostic category (mild cognitive impairment, MCI, pre-Alzheimer’s disease, early cognitive decline, early onset Alzheimer’s disease, and preclinical Alzheimer’s disease) and the intervention or training conducted (intervention, training, stimulation, rehabilitation, or treatment). Other inclusion and exclusion criteria included subject selection based on established MCI criteria, RCT design in an outpatient setting, MCI controls (active or passive), and outcomes based on objective neuropsychological measures. From the 1199 abstracts identified, 26 articles met inclusion criteria for the meta-analyses completed across eleven (11) countries; 92.31% of which have been published within the past 7 years. A series of meta-analyses were performed to examine the effects of cognitive intervention by cognitive domain, type of training, and intervention content (cognitive domain targeted). We found significant, moderate effects for multicomponent training (Hedges’ g observed = 0.398; CI [0.164, 0.631]; Z = 3.337; p = 0.001; Q = 55.511; df = 15; p = 0.000; I2 = 72.978%; τ2 = 0.146) as well as multidomain-focused strategies (Hedges’ g = 0.230; 95% CI [0.108, 0.352]; Z = 3.692; p < 0.001; Q = 12.713; df = 12; p = 0.390; I2 = 5.612; τ2 = 0.003). The effects for other interventions explored by cognitive domain, training type, or intervention content were indeterminate due to concerns for heterogeneity, bias, and small cell sizes. In addition, subgroup and meta-regression analyses were conducted with the moderators of MCI category, mode of intervention, training type, intervention content, program duration (total hours), type of control group (active or passive), post-intervention follow-up assessment period, and control for repeat administration. We found significant overall effects for intervention content with memory focused interventions appearing to be more effective than multidomain approaches. There was no evidence of an influence on outcomes for the other covariates examined. Overall, these findings suggest individuals with MCI who received multicomponent training or interventions targeting multiple domains (including lifestyle changes) were apt to display an improvement on outcome measures of cognition post-intervention. As such, multicomponent and multidomain forms of intervention may prompt recruitment of alternate neural processes as well as support primary networks to meet task demands simultaneously. In addition, interventions with memory and multidomain forms of content appear to be particularly helpful, with memory-based approaches possibly being more effective than multidomain methods. Other factors, such as program duration, appear to have less of an influence on intervention outcomes. Given this, although the creation of new primary network paths appears strained in MCI, interventions with memory-based or multidomain forms of content may facilitate partial activation of compensatory scaffolding and neuroplastic reorganization. The positive benefit of memory-based strategies may also reflect transfer effects indicative of compensatory network activation and the multiple-pathways involved in memory processes. Limitations of this review are similar to other meta-analysis in MCI, including a modest number studies, small sample sizes, multiple forms of interventions and types of training applied (some overlapping), and, while greatly improved in our view, a large diversity of instruments used to measure outcome. This is apt to have contributed to the presence of heterogeneity and publication bias precluding a more definitive determination of the outcomes observed.
Collapse
Affiliation(s)
- Dale S Sherman
- Cedars-Sinai Medical Center, 444 S. San Vicente Blvd, Suite 103, Los Angeles, CA, 90048, USA. .,University of Southern California, Los Angeles, CA, USA.
| | - Justin Mauser
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Miriam Nuno
- University of California, Davis, Davis, CA, USA
| | - Dean Sherzai
- Loma Linda University Health, 11370 Anderson Street B100, Loma Linda, CA, 92354, USA
| |
Collapse
|
15
|
Guerini FR, Farina E, Costa AS, Baglio F, Saibene FL, Margaritella N, Calabrese E, Zanzottera M, Bolognesi E, Nemni R, Clerici M. ApoE and SNAP-25 Polymorphisms Predict the Outcome of Multidimensional Stimulation Therapy Rehabilitation in Alzheimer’s Disease. Neurorehabil Neural Repair 2016; 30:883-93. [DOI: 10.1177/1545968316642523] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Alzheimer’s disease (AD) is a highly prevalent neurodegenerative disorder. Rate of decline and functional restoration in AD greatly depend on the capacity for neural plasticity within residual neural tissues; this is at least partially influenced by polymorphisms in genes that determine neural plasticity, including Apolipoprotein E4 ( ApoE4) and synaptosomal-associated protein of 25 kDa ( SNAP-25). Objective. We investigated whether correlations could be detected between polymorphisms of ApoE4 and SNAP-25 and the outcome of a multidimensional rehabilitative approach, based on cognitive stimulation, behavioral, and functional therapy (multidimensional stimulation therapy [MST]). Methods. Fifty-eight individuals with mild-to-moderate AD underwent MST for 10 weeks. Neuro-psychological functional and behavioral evaluations were performed blindly by a neuropsychologist at baseline and after 10 weeks of therapy using Mini-Mental State Examination (MMSE), Functional Living Skill Assessment (FLSA), and Neuropsychiatric Inventory (NPI) scales. Molecular genotyping of ApoE4 and SNAP-25 rs363050, rs363039, rs363043 was performed. Results were correlated with ΔMMSE, ΔNPI and ΔFLSA scores by multinomial logistic regression analysis. Results. Polymorphisms in both genes correlated with the outcome of MST for MMSE and NPI scores. Thus, higher overall MMSE scores after rehabilitation were detected in ApoE4 negative compared to ApoE4 positive patients, whereas the SNAP-25 rs363050(G) and rs363039(A) alleles correlated with significant improvements in behavioural parameters. Conclusions. Polymorphisms in genes known to modulate neural plasticity might predict the outcome of a multistructured rehabilitation protocol in patients with AD. These data, although needing confirmation on larger case studies, could help optimizing the clinical management of individuals with AD, for example defining a more intensive treatment in those subjects with a lower likelihood of success.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Raffaello Nemni
- Don C. Gnocchi Foundation IRCCS, Milan, Italy
- University of Milan, Milan, Italy
| | - Mario Clerici
- Don C. Gnocchi Foundation IRCCS, Milan, Italy
- University of Milan, Milan, Italy
| |
Collapse
|
16
|
Feng W, Yokoyama JS, Yu S, Chen Y, Cheng Y, Bonham LW, Wang D, Shen Y, Wu W, Li C. APOE Genotype Affects Cognitive Training Response in Healthy Shanghai Community-Dwelling Elderly Individuals. J Alzheimers Dis 2015; 47:1035-46. [PMID: 26401781 PMCID: PMC5799000 DOI: 10.3233/jad-150039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive training may contribute to the ability to maintain cognitive function in healthy elderly adults. Whether genotype modifies training effects remains unknown. OBJECTIVE Assess influence of APOE on cognitive function over time in community-dwelling elderly adults participating in multi-domain cognitive training. METHODS Healthy individuals ≥70 years of age were screened from one urban community in Shanghai. 145 healthy Chinese older adults met inclusion criteria and were assigned to intervention (n = 88) or control (n = 57) groups. Multi-domain cognitive training involved 24 sessions of different content taking place over 12 weeks. Neuropsychological testing was administered at baseline, immediately after training, six months and twelve months post-intervention; composite measures of cognitive function were identified via factor analysis. RESULTS Three factors explained the majority of variance in function (verbal memory, processing speed, executive function). The intervention attenuated 12-month declines in processing speed, regardless of APOE genotype (p = 0.047). Executive function declined in APOEɛ4 carriers over 12 months, regardless of intervention (p = 0.056). There was a significant interaction after 12 months where intervention ɛ4 carriers had better processing speed than ɛ4 controls (p = 0.003). Intervention ɛ2 carriers had better executive function immediately after training (p = 0.02) and had better verbal memory 6-months post-intervention (p = 0.04). These effects remained significant after false-discovery rate correction. CONCLUSION Multi-domain cognitive training reduces declines in processing speed over time. APOEɛ4 is associated with reductions in executive function over time, and training may attenuate ɛ4-associated declines in processing speed. APOEɛ2 carriers may also benefit from training, particularly on measures of executive function and verbal memory.
Collapse
Affiliation(s)
- Wei Feng
- Department of Psychiatry, Tongji Hospital, Tongji University, Shanghai, P.R. China
| | - Jennifer S. Yokoyama
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Shunying Yu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - You Chen
- Shanghai Yangpu District Mental Health Center, Shanghai, P.R. China
| | - Yan Cheng
- Department of Psychiatry, Tongji Hospital, Tongji University, Shanghai, P.R. China
| | - Luke W. Bonham
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Dongxiang Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Yuan Shen
- Department of Psychiatry, Tenth People’s Hospital of Tongji University, Shanghai, P.R. China
| | - Wenyuan Wu
- Department of Psychiatry, Tongji Hospital, Tongji University, Shanghai, P.R. China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| |
Collapse
|