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Lee WJ, Peng LN, Lin MH, Kim S, Hsiao FY, Chen LK. Enhancing Intrinsic Capacity and Related Biomarkers in Community-Dwelling Multimorbid Older Adults Through Integrated Multidomain Interventions: Ancillary Findings From the Taiwan Integrated Geriatric (TIGER) Trial. J Am Med Dir Assoc 2024; 25:757-763.e4. [PMID: 37949432 DOI: 10.1016/j.jamda.2023.10.006] [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: 09/05/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of integrated multidomain interventions and primary health care on intrinsic capacity (IC) and related biomarkers. DESIGN An ancillary analysis from the Taiwan Integrated Geriatric Care (TIGER) study: a randomized controlled trial. SETTING AND PARTICIPANTS A total of 398 community-dwelling older adults aged ≥65 years with ≥3 chronic conditions. METHODS Participants were randomized into the 12-month pragmatic multidomain intervention or usual care groups. The primary outcome was the change in IC and its subdomains (locomotion, cognition, vitality, psychological, and sensory) at baseline and 3-, 6-, 9-, and 12-month follow-ups. Generalized linear mixed models were used to evaluate the multidomain intervention effects on these changes. RESULTS The intervention arm had greater improvement in IC than the usual care arm (overall difference 1.5; 95% CI 0.5-2.5; P = .005), mainly from subdomains of locomotion (overall difference 1.4; 95% CI 0.5-2.4; P = .004) and cognition (2.9; 95% CI 2.1-3.7; P < .001). Changes in neutrophil-to-lymphocyte ratio (NLR -2.4; 95% CI -3.9 to -0.8, P = .003), serum levels of albumin (35.1; 95% CI 23.1-47.2; P < .001), dehydroepiandrosterone sulfate (DHEA-S 2.8; 95% CI 1.9-3.8; P < .001), free androgen index (FAI 1.5; 95% CI 1.1-1.9; P < .001), and vitamin D (4.0; 95% CI 2.0-6.1; P < .001) were associated with changes in IC over time. CONCLUSIONS AND IMPLICATIONS The incorporation of multidomain interventions into primary health care significantly enhanced IC over the 12-month program. Changes in NLR, FAI, and serum levels of albumin, DHEA-S, vitamin D were associated with changes in IC over time. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03528005.
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Affiliation(s)
- Wei-Ju Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan County, Taiwan.
| | - Li-Ning Peng
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Hsien Lin
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
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2
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Novikova MS, Zaharov VV. [Predictors of the efficacy of non-drug treatments for non-dementia vascular cognitive impairment]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:83-88. [PMID: 37315246 DOI: 10.17116/jnevro202312305183] [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: 06/16/2023]
Abstract
OBJECTIVE To study the predictors of the efficacy of non-drug multimodal therapy in the treatment of mild vascular cognitive impairment. MATERIAL AND METHODS Thirty patients with mild vascular cognitive impairment, under the supervision of their physician, received a 1-month non-drug treatment program including cognitive training, detailed recommendations for physical activity, and dietary planning. RESULTS After the end of the course of treatment, improvements in the MoCa test were achieved by 22 patients (73%), which made up Group 1. In the remaining 8 patients, the treatment had no effect (Group 2). In Group 1, the dynamics of the MoCa test averaged 1.7±0.9, in the Group 2 it was (-0.4)±0.5. Patients of Group 1 had a significantly lower level of education (10.9±2.3) compared with Group 2 (14.9±2.0), a higher initial MoCa score, and a less pronounced white matter lesion on the Fazekas scale. After the regression analysis, the level of education (B -0.999, p<0.05) and white matter damage (B -2.761, p<0.01) were significant predictors. CONCLUSION When using non-drug multimodal therapy in the treatment of mild vascular cognitive impairment, lower levels of education and a lower degree of white matter vascular damage are reliable predictors of treatment efficacy.
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Affiliation(s)
- M S Novikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V V Zaharov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Rydström A, Darin-Mattsson A, Kåreholt I, Ngandu T, Lehtisalo J, Solomon A, Antikainen R, Bäckman L, Hänninen T, Laatikainen T, Levälahti E, Lindström J, Paajanen T, Havulinna S, Peltonen M, Sindi S, Soininen H, Neely AS, Strandberg T, Tuomilehto J, Kivipelto M, Mangialasche F. Occupational complexity and cognition in the FINGER multidomain intervention trial. Alzheimers Dement 2022; 18:2438-2447. [PMID: 35142055 DOI: 10.1002/alz.12561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/21/2021] [Accepted: 12/03/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Lifetime exposure to occupational complexity is linked to late-life cognition, and may affect benefits of preventive interventions. METHODS In the 2-year multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated, through post hoc analyses (N = 1026), the association of occupational complexity with cognition. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles. RESULTS Higher levels of occupational complexity were associated with better baseline cognition. Measures of occupational complexity had no association with intervention effects on cognition, except for occupational complexity with data, which was associated with the degree of intervention-related gains for executive function. DISCUSSION In older adults at increased risk for dementia, higher occupational complexity is associated with better cognition. The cognitive benefit of the FINGER intervention did not vary significantly among participants with different levels of occupational complexity. These exploratory findings require further testing in larger studies.
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Affiliation(s)
- Anders Rydström
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alexander Darin-Mattsson
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Institute of Gerontology, School of Health and Welfare, Aging Research Network - Jönköping (ARN-J), Jönköping University, Jönköping, Sweden
| | - Tiia Ngandu
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Lehtisalo
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and Oulu City Hospital, Oulu, Finland
| | - Lars Bäckman
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Tuomo Hänninen
- Neurocenter/Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Hospital District of North Karelia, Joensuu, Finland
| | - Esko Levälahti
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Satu Havulinna
- Department of Welfare; Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markku Peltonen
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurocenter/Neurology, Kuopio University Hospital, Kuopio, Finland
| | | | - Timo Strandberg
- Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland.,University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,South Ostrobothnia Central Hospital, Seinäjoki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Theme Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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An J, Sun W, Zhang W, Yu Z, Gao K, Zhao J, Sun S, An J, Ji A. Cognition in chronic kidney disease patients: Evaluation with the Beijing version of the Montreal Cognitive Assessment. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:520-526. [PMID: 32608267 DOI: 10.1080/23279095.2020.1778477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patients with chronic kidney disease (CKD) may undergo cognitive impairment. We aimed to explore the cognition of patients with cognitive impairment (CI) and no cognitive impairment (NCI) respectively and the effect of demographics, estimated glomerular filtration rate (eGFR), number of comorbidities (NCD), and hemoglobin on CI in Chinese patients with CKD at stage 3-5 treated by nondialysis by using the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ). A total of 120 patients with CKD were recruited from the Department of Nephrology at the Affiliated Hospital of Nanjing University of Chinese Medicine at in-patient and out-patient follow up. A logistic regression model was performed to assess the effect of these variables on CI of CKD patients. The results indicated that the CI group was mainly in the decline of visuospatial and executive function, abstraction, and memory, compared with the NCI group. In addition, years of education, eGFR and NCD were found as predictors of CI of CKD patients at stage 3-5. Specifically, lower eGFR, less years of education and more comorbidities were risk predictors of CI.
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Affiliation(s)
- Jinlong An
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Wei Sun
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenjun Zhang
- First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Zhongxian Yu
- First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Kun Gao
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Zhao
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Sifan Sun
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing An
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing, China.,School of Economics and Management, Changzhou Institute of Technology, Changzhou, China
| | - Aifeng Ji
- Nanjing Zutangshan Mental Hospital, Nanjing, China
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Dynamic Useful Field of View Training to Enhance Older Adults’ Cognitive and Motor Function: a Pilot Study. JOURNAL OF COGNITIVE ENHANCEMENT 2021; 5:411-419. [DOI: 10.1007/s41465-021-00219-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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Ferreira ACDS, Silva AA, Paiva LR, Satler C, Cera ML. Intensive naming training for low-educated demented and non-demented elderly. Dement Neuropsychol 2020; 14:403-411. [PMID: 33354294 PMCID: PMC7735057 DOI: 10.1590/1980-57642020dn14-040011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT. Complaints about naming difficulties may be common in the elderly. In dementia, anomia is the most frequent symptom of language disorders. Naming training can improve lexical access and promote better quality of communication for elderly with or without dementia. Objective: To analyze naming scores, response time and the generalization of responses for naming of neurotypical and demented low-educated older adults before and after receiving a naming training program, with and without oral comprehension stimulation. Method: Twenty elderly participants, 10 with dementia and 10 neurotypical, were included after interview, screening for cognition and functionality. The naming training was based on retrieval practice and carried out in 5 sessions. Half of the group underwent exclusive naming training, while the other half received naming training associated with oral comprehension stimulation. Results: Elderly people with dementia performed better after training for scores on oral naming and comprehension of oral words, except for object manipulation. The response time for naming trained and untrained stimuli was also better for elderly people with dementia. After the intervention, neurotypical individuals performed statistically better in comprehension time and in the score in oral naming, comprehension of oral words and object manipulation, for trained and untrained words. Conclusion: Naming training, exclusive or associated with oral comprehension, using the recovery technique benefits the language performance of neurotypical and demented elderly, and provides improvements even for untrained stimuli.
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Ophey A, Roheger M, Folkerts AK, Skoetz N, Kalbe E. A Systematic Review on Predictors of Working Memory Training Responsiveness in Healthy Older Adults: Methodological Challenges and Future Directions. Front Aging Neurosci 2020; 12:575804. [PMID: 33173503 PMCID: PMC7591761 DOI: 10.3389/fnagi.2020.575804] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Research on predictors of working memory training responsiveness, which could help tailor cognitive interventions individually, is a timely topic in healthy aging. However, the findings are highly heterogeneous, reporting partly conflicting results following a broad spectrum of methodological approaches to answer the question “who benefits most” from working memory training. Objective: The present systematic review aimed to systematically investigate prognostic factors and models for working memory training responsiveness in healthy older adults. Method: Four online databases were searched up to October 2019 (MEDLINE Ovid, Web of Science, CENTRAL, and PsycINFO). The inclusion criteria for full texts were publication in a peer-reviewed journal in English/German, inclusion of healthy older individuals aged ≥55 years without any neurological and/or psychiatric diseases including cognitive impairment, and the investigation of prognostic factors and/or models for training responsiveness after targeted working memory training in terms of direct training effects, near-transfer effects to verbal and visuospatial working memory as well as far-transfer effects to other cognitive domains and behavioral variables. The study design was not limited to randomized controlled trials. Results: A total of 16 studies including n = 675 healthy older individuals with a mean age of 63.0–86.8 years were included in this review. Within these studies, five prognostic model approaches and 18 factor finding approaches were reported. Risk of bias was assessed using the Quality in Prognosis Studies checklist, indicating that important information, especially regarding the domains study attrition, study confounding, and statistical analysis and reporting, was lacking throughout many of the investigated studies. Age, education, intelligence, and baseline performance in working memory or other cognitive domains were frequently investigated predictors across studies. Conclusions: Given the methodological shortcomings of the included studies, no clear conclusions can be drawn, and emerging patterns of prognostic effects will have to survive sound methodological replication in future attempts to promote precision medicine approaches in the context of working memory training. Methodological considerations are discussed, and our findings are embedded to the cognitive aging literature, considering, for example, the cognitive reserve framework and the compensation vs. magnification account. The need for personalized cognitive prevention and intervention methods to counteract cognitive decline in the aging population is high and the potential enormous. Registration: PROSPERO, ID CRD42019142750.
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Affiliation(s)
- Anja Ophey
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Roheger M, Folkerts AK, Krohm F, Skoetz N, Kalbe E. Prognostic factors for change in memory test performance after memory training in healthy older adults: a systematic review and outline of statistical challenges. Diagn Progn Res 2020; 4:7. [PMID: 32478173 PMCID: PMC7240921 DOI: 10.1186/s41512-020-0071-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The goal is to investigate prognostic factors for change in memory test performance in healthy older adults and to report and discuss the different statistical procedures used for investigating this topic in the literature. METHODS Prognostic factors were here understood as any measures that were investigated to estimate change in memory test performance. MEDLINE, Web of Science Core Collection, CENTRAL, and PsycInfo were searched up to November 2019. Prognostic factor and prognostic factor finding studies investigating prognostic factors on verbal and non-verbal short- and long-term memory after conducting memory training in healthy older adults were included. Risk of bias was assessed using the QUIPS tool. RESULTS Our search yielded 12,974 results. We included 29 studies that address prognostic factors of change in memory test performance, including sociodemographic, (neuro-)psychological, genetic, and biological parameters. Studies showed high variation and methodological shortcomings with regard to the assessment, statistical evaluation, and reporting of the investigated prognostic factors. Included studies used different types of dependent variables (change scores vs. post-test scores) when defining change in memory test performance leading to contradictory results. Age was the only variable investigated throughout most of the studies, showing that older adults benefit more from training when using the change score as the dependent variable. CONCLUSION Overall, there is a need for adequate reporting in studies of prognostic factors for change in memory test performance. Because of inconsistencies and methodological shortcomings in the literature, conclusions regarding prognostic factors remain uncertain. As a tentative conclusion, one may say that the higher the age of the participant, the more profound the improvement in memory test performance will be after memory training. TRIAL REGISTRATION CRD42019127479.
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Affiliation(s)
- Mandy Roheger
- grid.6190.e0000 0000 8580 3777Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 68, 50937 Cologne, Germany
| | - Ann-Kristin Folkerts
- grid.6190.e0000 0000 8580 3777Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 68, 50937 Cologne, Germany
| | - Fabian Krohm
- grid.6190.e0000 0000 8580 3777Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 68, 50937 Cologne, Germany
| | - Nicole Skoetz
- grid.6190.e0000 0000 8580 3777Evidence-Based Oncology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Elke Kalbe
- grid.6190.e0000 0000 8580 3777Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 68, 50937 Cologne, Germany
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Clark DO, Xu H, Moser L, Adeoye P, Lin AW, Tangney CC, Risacher SL, Saykin AJ, Considine RV, Unverzagt FW. MIND food and speed of processing training in older adults with low education, the MINDSpeed Alzheimer's disease prevention pilot trial. Contemp Clin Trials 2019; 84:105814. [PMID: 31326523 PMCID: PMC6721976 DOI: 10.1016/j.cct.2019.105814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/11/2019] [Accepted: 07/16/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple national organizations and leaders have called for increased attention to dementia prevention in those most vulnerable, for example persons with limited formal education. Prevention recommendations have included calls for multicomponent interventions that have the potential to improve both underlying neurobiological health and the ability to function despite neurobiological pathology, or what has been termed cognitive reserve. OBJECTIVES Test feasibility, treatment modifier, mechanism, and cognitive function effects of a multicomponent intervention consisting of foods high in polyphenols (i.e., MIND foods) to target neurobiological health, and speed of processing training to enhance cognitive reserve. We refer to this multicomponent intervention as MINDSpeed. DESIGN MINDSpeed is being evaluated in a 2 × 2 randomized factorial design with 180 participants residing independently in a large Midwestern city. Qualifying participants are 60 years of age or older with no evidence of dementia, and who have completed 12 years or less of education. All participants receive a study-issued iPad to access the custom study application that enables participants, depending on randomization, to select either control or MIND food, and to play online cognitive games, either speed of processing or control games. METHODS All participants complete informed consent and baseline assessment, including urine and blood samples. Additionally, up to 90 participants will complete neuroimaging. Assessments are repeated immediately following 12 weeks of active intervention, and at 24 weeks post-randomization. The primary outcome is an executive cognitive composite score. Secondary outcomes include oxidative stress, pro-inflammatory cytokines, and neuroimaging-captured structural and functional metrics of the hippocampus and cortical brain regions. SUMMARY MINDSpeed is the first study to evaluate the multicomponent intervention of high polyphenol intake and speed of processing training. It is also one of the first dementia prevention trials to target older adults with low education. The results of the study will guide future dementia prevention efforts and trials in high risk populations.
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Affiliation(s)
- Daniel O Clark
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America; Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, United States of America.
| | - Huiping Xu
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America; Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States of America
| | - Lyndsi Moser
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Philip Adeoye
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America
| | - Annie W Lin
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States of America
| | - Christy C Tangney
- Department of Clinical Nutrition, Rush University Medical Center, Chicago, IL, United States of America
| | - Shannon L Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Robert V Considine
- Department of Medicine, Division of Endocrinology, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Frederick W Unverzagt
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States of America
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Matysiak O, Kroemeke A, Brzezicka A. Working Memory Capacity as a Predictor of Cognitive Training Efficacy in the Elderly Population. Front Aging Neurosci 2019; 11:126. [PMID: 31214015 PMCID: PMC6554703 DOI: 10.3389/fnagi.2019.00126] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 05/13/2019] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with a decline in a wide range of cognitive functions and working memory (WM) deterioration is considered a main factor contributing to this. Therefore, any attempt to counteract WM decline seems to have a potential benefit for older adults. However, determination of whether such methods like WM trainings are effective is a subject of a serious debate in the literature. Despite a substantial number of training studies and several meta-analyses, there is no agreement on the matter of their effectiveness. The other important and still not fully explored issue is the impact of the preexisting level of intellectual functioning on the training's outcome. In our study we investigated the impact of WM training on variety of cognitive tasks performance among older adults and the impact of the initial WM capacity (WMC) on the training efficiency. 85 healthy older adults (55-81 years of age; 55 female, 30 males) received 5 weeks of training on adaptive dual N-back task (experimental group) or memory quiz (active controls). Cognitive performance was assessed before and after intervention with measures of WM, memory updating, inhibition, attention shifting, short-term memory (STM) and reasoning. We found post-intervention group independent improvements across all cognitive tests except for inhibition and STM. With multi-level analysis individual learning curves were modeled, which enabled examining of the intra-individual change in training and inter-individual differences in intra-individual changes. We observed a systematic and positive, but relatively small, learning trend with time. Moderator analyses with demographic characteristics as moderators showed no additional effects on learning curves. Only initial WMC level was a significant moderator of training effectiveness. Older adults with initially lower WMC improved less and reached lower levels of performance, compared to the group with higher WMC. Overall, our findings are in accordance with the research suggesting that post-training gains are within reach of older adults. Our data provide evidence supporting the presence of transfer after N-back training in older adults. More importantly, our findings suggest that it is more important to take into account an initial WMC level, rather than demographic characteristics when evaluating WM training in older adults.
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Affiliation(s)
- Olga Matysiak
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Aleksandra Kroemeke
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Aneta Brzezicka
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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López-Higes R, Prados JM, Rubio-Valdehita S, Rodríguez-Rojo I, de Frutos-Lucas J, Montenegro M, Montejo P, Prada D, Losada MLD. Factors Explaining Language Performance After Training in Elders With and Without Subjective Cognitive Decline. Front Aging Neurosci 2018; 10:264. [PMID: 30233353 PMCID: PMC6129583 DOI: 10.3389/fnagi.2018.00264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/14/2018] [Indexed: 11/17/2022] Open
Abstract
The present study explores if cognitive reserve, executive functions, and working memory capacity are predictive of performance in the language domain (specifically in sentence comprehension and naming) after a cognitive training intervention. Sixty-six Spanish older adults voluntarily participated in the study, classified either as older adults with subjective cognitive decline according to Jessen et al.’s (2014) criteria (n = 35; 70.94 ± 4.16 years old) or cognitively intact (n = 31; 71.34 ± 4.96 years old). Written sentence comprehension and visual confrontation naming were assessed both immediately after recruitment (at the baseline), and then 6 months later, once each participant had completed his/her cognitive training (a well-known program in Spain, called UMAM; English translation: Madrid City Council Memory Unit Program). Cognitive reserve, executive functions (cognitive flexibility and controlled interference efficiency), and working memory capacity were measured for all participants at the baseline. Results pointed out that the subjective cognitive decline group presented greater benefits in the language domain than cognitively intact participants. We also observed that lower executive functioning and working memory capacity at the baseline predicted larger benefits in language performance after training, but only in the group of cognitively intact older adults. However, selected predictors hardly explained subjective cognitive decline participants’ results in language performance after training.
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Affiliation(s)
- Ramón López-Higes
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jose M Prados
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | | | - Inmaculada Rodríguez-Rojo
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center of Biomedical Technology, Polytechnical University - Complutense University, Madrid, Spain
| | - Jaisalmer de Frutos-Lucas
- Laboratory of Cognitive and Computational Neuroscience, Center of Biomedical Technology, Polytechnical University - Complutense University, Madrid, Spain.,Centre for the Prevention of Cognitive Impairment, Madrid, Spain
| | - Mercedes Montenegro
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Pedro Montejo
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - David Prada
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - María L D Losada
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
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López-Higes R, Martín-Aragoneses MT, Rubio-Valdehita S, Delgado-Losada ML, Montejo P, Montenegro M, Prados JM, de Frutos-Lucas J, López-Sanz D. Efficacy of Cognitive Training in Older Adults with and without Subjective Cognitive Decline Is Associated with Inhibition Efficiency and Working Memory Span, Not with Cognitive Reserve. Front Aging Neurosci 2018; 10:23. [PMID: 29456502 PMCID: PMC5801297 DOI: 10.3389/fnagi.2018.00023] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/18/2018] [Indexed: 12/21/2022] Open
Abstract
The present study explores the role of cognitive reserve, executive functions, and working memory (WM) span, as factors that might explain training outcomes in cognitive status. Eighty-one older adults voluntarily participated in the study, classified either as older adults with subjective cognitive decline or cognitively intact. Each participant underwent a neuropsychological assessment that was conducted both at baseline (entailing cognitive reserve, executive functions, WM span and depressive symptomatology measures, as well as the Mini-Mental State Exam regarding initial cognitive status), and then 6 months later, once each participant had completed the training program (Mini-Mental State Exam at the endpoint). With respect to cognitive status the training program was most beneficial for subjective cognitive decline participants with low efficiency in inhibition at baseline (explaining a 33% of Mini-Mental State Exam total variance), whereas for cognitively intact participants training gains were observed for those who presented lower WM span.
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Affiliation(s)
- Ramón López-Higes
- Department of Cognitive Processes, Complutense University of Madrid, Madrid, Spain
| | - María T Martín-Aragoneses
- Department of Methods of Research and Diagnostic in Education, Universidad Nacional de Educación a Distancia, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Madrid, Spain
| | - Susana Rubio-Valdehita
- Department of Differential and Occupational Psychology, Complutense University of Madrid, Madrid, Spain
| | | | - Pedro Montejo
- Center for the Prevention of Cognitive Impairment, Madrid-Salud, Madrid, Spain
| | - Mercedes Montenegro
- Center for the Prevention of Cognitive Impairment, Madrid-Salud, Madrid, Spain
| | - José M Prados
- Department of Cognitive Processes, Complutense University of Madrid, Madrid, Spain
| | | | - David López-Sanz
- Laboratory of Cognitive and Computational Neuroscience, Madrid, Spain
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Edwards JD, Xu H, Clark DO, Guey LT, Ross LA, Unverzagt FW. Speed of processing training results in lower risk of dementia. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2017; 3:603-611. [PMID: 29201994 PMCID: PMC5700828 DOI: 10.1016/j.trci.2017.09.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Cognitive training improves cognitive performance and delays functional impairment, but its effects on dementia are not known. We examined whether three different types of cognitive training lowered the risk of dementia across 10 years of follow-up relative to control and if greater number of training sessions attended was associated with lower dementia risk. METHODS The Advanced Cognitive Training in Vital Elderly (NCT00298558) study was a randomized controlled trial (N = 2802) among initially healthy older adults, which examined the efficacy of three cognitive training programs (memory, reasoning, or speed of processing) relative to a no-contact control condition. Up to 10 training sessions were delivered over 6 weeks with up to four sessions of booster training delivered at 11 months and a second set of up to four booster sessions at 35 months. Outcome assessments were taken immediately after intervention and at intervals over 10 years. Dementia was defined using a combination of interview- and performance-based methods. RESULTS A total of 260 cases of dementia were identified during the follow-up. Speed training resulted in reduced risk of dementia (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.50-0.998, P = .049) compared to control, but memory and reasoning training did not (HR 0.79, 95% CI 0.57-1.11, P = .177 and HR 0.79, 95% CI 0.56-1.10, P = .163, respectively). Each additional speed training session was associated with a 10% lower hazard for dementia (unadjusted HR, 0.90; 95% CI, 0.85-0.95, P < .001). DISCUSSION Initially, healthy older adults randomized to speed of processing cognitive training had a 29% reduction in their risk of dementia after 10 years of follow-up compared to the untreated control group.
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Affiliation(s)
- Jerri D. Edwards
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
| | - Huiping Xu
- Department of Biostatistics, The Richard M. Fairbanks School of Public Health and School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Daniel O. Clark
- Department of Medicine, Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA
| | | | - Lesley A. Ross
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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Bahar-Fuchs A, Webb S, Bartsch L, Clare L, Rebok G, Cherbuin N, Anstey KJ. Tailored and Adaptive Computerized Cognitive Training in Older Adults at Risk for Dementia: A Randomized Controlled Trial. J Alzheimers Dis 2017; 60:889-911. [DOI: 10.3233/jad-170404] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Alex Bahar-Fuchs
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
- Academic Unit for Psychiatry of Old Age, Parkville, The University of Melbourne, VIC, Australia
| | - Shannon Webb
- School of Psychology, Griffith Taylor Building, The University of Sydney, New South Wales, Australia
| | - Lauren Bartsch
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, Washington Singer Laboratories, The University of Exeter, UK
| | - George Rebok
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
| | - Kaarin J. Anstey
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
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Cognitive Interventions for Cognitively Healthy, Mildly Impaired, and Mixed Samples of Older Adults: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials. Neuropsychol Rev 2017; 27:403-439. [PMID: 28726168 DOI: 10.1007/s11065-017-9350-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 05/15/2017] [Indexed: 01/09/2023]
Abstract
Cognitive interventions may improve cognition, delay age-related cognitive declines, and improve quality of life for older adults. The current meta-analysis was conducted to update and expand previous work on the efficacy of cognitive interventions for older adults and to examine the impact of key demographic and methodological variables. EBSCOhost and Embase online databases and reference lists were searched to identify relevant randomized-controlled trials (RCTs) of cognitive interventions for cognitively healthy or mildly impaired (MCI) older adults (60+ years). Interventions trained a single cognitive domain (e.g., memory) or were multi-domain training, and outcomes were assessed immediately post-intervention using standard neuropsychological tests. In total, 279 effects from 97 studies were pooled based on a random-effects model and expressed as Hedges' g (unbiased). Overall, results indicated that cognitive interventions produce a small, but significant, improvement in the cognitive functioning of older adults, relative to active and passive control groups (g = 0.298, p < .001, 95% CI = 0.248-0.347). These results were confirmed using multi-level analyses adjusting for nesting of effect sizes within studies (g = 0.362, p < .001, 95% CI = 0.275, 0.449). Age, education, and cognitive status (healthy vs. MCI) were not significant moderators. Working memory interventions proved most effective (g = 0.479), though memory, processing speed, and multi-domain interventions also significantly improved cognition. Effects were larger for directly trained outcomes but were also significant for non-trained outcomes (i.e., "transfer effects"). Implications for future research and clinical practice are discussed. This project was pre-registered with PROSPERO (#42016038386).
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Fu L, Maes JHR, Kessels RPC, Daselaar SM. To boost or to CRUNCH? Effect of effortful encoding on episodic memory in older adults is dependent on executive functioning. PLoS One 2017; 12:e0174217. [PMID: 28328979 PMCID: PMC5362088 DOI: 10.1371/journal.pone.0174217] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 03/06/2017] [Indexed: 02/04/2023] Open
Abstract
It is essential to develop effective interventions aimed at ameliorating age-related cognitive decline. Previous studies found that effortful encoding benefits episodic memory in older adults. However, to date it is unclear whether this benefit is different for individuals with strong versus weak executive functioning (EF). Fifty-one older adults were recruited and divided into low (N = 26) and high (N = 25) functioning groups, based on their EF capacity. All participants performed a semantic and a perceptual incidental encoding task. Each encoding task was performed under four difficulty levels to establish different effort levels. Encoding was followed by a recognition task. Results showed that the high EF group benefitted from increased effort in both tasks. However, the low EF group only showed a beneficial effect under low levels of effort. Results are consistent with the Compensation-Related Utilization of Neural Circuits Hypothesis (CRUNCH) and suggest that future research directed at developing efficient memory strategies to reduce negative cognitive aging effects should take individual cognitive differences among older adults into account, such as differences in EF.
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Affiliation(s)
- Li Fu
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- * E-mail:
| | - Joseph H. R. Maes
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sander M. Daselaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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Bureš V, Čech P, Mikulecká J, Ponce D, Kuca K. The effect of cognitive training on the subjective perception of well-being in older adults. PeerJ 2016; 4:e2785. [PMID: 28028465 PMCID: PMC5180580 DOI: 10.7717/peerj.2785] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 11/11/2016] [Indexed: 02/03/2023] Open
Abstract
Background There is a growing number of studies indicating the major consequences of the subjective perception of well-being on mental health and healthcare use. However, most of the cognitive training research focuses more on the preservation of cognitive function than on the implications of the state of well-being. This secondary analysis of data from a randomised controlled trial investigated the effects of individualised television-based cognitive training on self-rated well-being using the WHO-5 index while considering gender and education as influencing factors. The effects of cognitive training were compared with leisure activities that the elderly could be engaged in to pass time. Methods Cognitively healthy participants aged 60 years or above screened using the Mini-Mental State Examination (MMSE) and Major Depression Inventory (MDI) were randomly allocated to a cognitive training group or to an active control group in a single-blind controlled two-group design and underwent 24 training sessions. Data acquired from the WHO-5 questionnaire administered before and after intervention were statistically analysed using a mixed design model for repeated measures. The effect of individualised cognitive training was compared with leisure activities while the impact of gender and education was explored using estimated marginal means. Results A total of 81 participants aged 67.9 ± 5.59 [60–84] without cognitive impairments and absent of depression symptoms underwent the study. Participants with leisure time activities declared significantly higher scores compared to participants with cognitive training M = 73.48 ± 2.88, 95% CI [67.74–79.22] vs M = 64.13 ± 3.034, 95% CI [58.09–70.17] WHO-5 score. Gender and education were found to moderate the effect of cognitive training on well-being when compared to leisure activities. Females engaged in leisure activities in the control group reported higher by M = 9.77 ± 5.4, 95% CI [−0.99–20.54] WHO-5 scores than females with the cognitive training regimen. Participants with high school education declared leisure activities to increase WHO-5 scores by M = 14.59 ± 5.39, 95% CI [3.85–25.34] compared to individualised cognitive training. Discussion The findings revealed that individualised cognitive training was not directly associated with improvements in well-being. Changes in the control group indicated that involvement in leisure time activities, in which participants were partly free to choose from, represented more favourable stimulation to a self-perceived sense of well-being than individualised cognitive training. Results also supported the fact that gender and education moderated the effect of cognitive training on well-being. Females and participants with high school education were found to be negatively impacted in well-being when performance connected with cognitive training was expected.
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Affiliation(s)
- Vladimír Bureš
- Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic
| | - Pavel Čech
- Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic
| | - Jaroslava Mikulecká
- Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic
| | - Daniela Ponce
- Faculty of Informatics and Management, University of Hradec Kralove , Hradec Kralove , Czech Republic
| | - Kamil Kuca
- Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic; Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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