1
|
Fastame MC, Mulas I, Putzu V, Asoni G, Viale D, Mameli I, Pau M. The efficiency of activities of daily living (ADLs) skills in late adulthood: A mediational approach. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1132-1143. [PMID: 35981564 DOI: 10.1080/23279095.2022.2111261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The term "Activities of Daily Living" (ADLs) refers to a set of fundamental tasks (i.e., toileting, bathing, personal care, eating, grooming, and getting dressed) considered necessary for living and being autonomous in everyday life. Although in the clinical setting ADLs efficiency is a marker to diagnose dementia, limited evidence on the mechanism implicating muscular function and cognitive alterations in ADLs skills in late adulthood exists. This study primarily intended to determine the extent to which executive functions mediate between muscular strength, as assessed through handgrip strength (HGS) measurement, and ADLs skills of older community-dwellers. A further goal was to explore the impact of gender and cognitive status on ADLs and HGS scores, using education as a covariate. Three hundred and thirty-four older participants, 199 females and 135 males (Mage = 77.5 years, SD = 5.6 years, age range = 63-93 years) completed a battery of tests assessing ADLs, HGS, and executive functions. The results showed that 34-56% of the variance in the ADLs condition was explained by HGS and executive functioning. Furthermore, cognitively healthy participants exhibited better ADLs skills, whereas cognitively impaired individuals, both males and females, exhibited poorer HGS efficiency. In conclusion, in clinical settings, the concurrent evaluation of ADLs skills, motor, and higher-order cognitive processes should be encouraged to detect individuals needing a person-tailored intervention to boost their quality of life.
Collapse
Affiliation(s)
- Maria Chiara Fastame
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Ilaria Mulas
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Valeria Putzu
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Gesuina Asoni
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Daniela Viale
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Irene Mameli
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| |
Collapse
|
2
|
Wei Z, Zhao X, Liu Y. A meta-analysis of the consequences of cognitive training on the cognitive function of aged mild cognitive impairment patients. Psychogeriatrics 2024. [PMID: 39233461 DOI: 10.1111/psyg.13177] [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] [Received: 03/13/2024] [Revised: 07/19/2024] [Accepted: 07/28/2024] [Indexed: 09/06/2024]
Abstract
Cognitive training has gained popularity as a means to aid older adults with mild cognitive impairment (MCI), a transitional phase between normal ageing and Alzheimer's disease (AD). MCI represents a critical and potentially reversible state that can either improve or progress to full-blown dementia. This study aims to evaluate the impact of cognitive training on cognitive function in aged patients with MCI. PubMed, Embase, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases were systematically retrieved from inception until May 2024. We rigorously applied the risk-of-bias methodology recommended by the Cochrane Handbook to assess the quality of the included studies. After two rounds of screening and removing duplicates, a total of 2685 articles were initially identified, from which 28 met the inclusion criteria. The meta-analysis included 28 randomised controlled trials with 1960 participants. In this meta-analysis, Review Manager 5.4 was used for statistical analysis. Findings revealed that cognitive training significantly improved the global cognitive function in aged MCI patients, as evidenced by the results of the Montreal Cognitive Assessment (standard mean difference (SMD) = 3.26; 95% CI, 2.69-3.82; P < 0.00001) and Mini-Mental State Examination (SMD = 2.27; 95% CI, 1.52-3.01; P < 0.00001). The beneficial effects of cognitive training interventions were consistent regardless of duration, including periods of 2 months or less (SMD = 1.94; 95% CI, 1.25-2.63; P < 0.00001), 2 to 6 months (SMD = 2.53; 95% CI, 1.52-3.53; P < 0.00001), and over 6 months (SMD = 4.12; 95% CI, 0.97-7.27; P = 0.01). The analysis indicates that cognitive training significantly benefits overall cognitive function, delayed memory, orientation, attention, and language skills in aged patients with MCI. Furthermore, cognitive training interventions are effective in enhancing cognitive function, irrespective of their duration.
Collapse
Affiliation(s)
- Zhihui Wei
- School of Social Development, Tianjin University of Technology, Tianjin, China
| | - Xinrui Zhao
- School of Social Development, Tianjin University of Technology, Tianjin, China
| | - Yang Liu
- School of Social Development, Tianjin University of Technology, Tianjin, China
| |
Collapse
|
3
|
Dorociak KE, Bernstein JPK, Baumgartner SE, Hughes AM, Duff K, Lamberty GJ, Yamada TH. Cognitive and psychological improvements following CogSMART in veterans with mental health diagnoses. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:892-900. [PMID: 35696557 DOI: 10.1080/23279095.2022.2086056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The present study examined the efficacy of a CogSMART-based program in improving cognitive and emotional functioning in a clinic-based sample of Veterans presenting with cognitive concerns and history of mental health diagnoses. METHOD Forty Veterans (Mage = 61.2 years, 85% male) completed a weekly CogSMART-based group program as well as a battery of neuropsychological and psychological measures at both pre- and post-group evaluations. Participants met DSM-5 criteria for at least one mental health diagnosis. RESULTS Significant improvements on global cognition as well as measures of learning/memory and attention were observed from pre- to post-group (p < .05, cohen's d range = .48-1.01). As many as 33.3% of participants showed significant improvement, depending on the cognitive domain. Significant overall improvements were observed in depression symptoms and life satisfaction (p < .01, cohen's d = .67 and .59, respectively). Over one-third of the sample demonstrated a reliable improvement in depressive symptoms, 25% in anxiety symptoms, and 18% in life satisfaction. CONCLUSIONS Among individuals with mental health diagnosis but without major neurocognitive disorders, CogSMART-based interventions may be an effective treatment for improving aspects of cognition, depression, and life satisfaction.
Collapse
Affiliation(s)
| | | | | | | | - Kevin Duff
- Neurology, University of Utah, Salt Lake City, United States
| | | | | |
Collapse
|
4
|
Cheng C, Zheng M, Yan F, Wu Y, Li T, Cao Z, Yue J, Chen P, Zheng Z, Fan T, Li C, Cui P. A chain mediation model reveals the association between metacognition and quality of life in hematologic tumor patients. Sci Rep 2024; 14:18446. [PMID: 39117715 PMCID: PMC11310524 DOI: 10.1038/s41598-024-69027-w] [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: 01/30/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024] Open
Abstract
The study aims to explore the relationship among metacognition (MC), fear of disease of progression (FoP), psychological distress (PD), and quality of life (QoL), and verify whether FoP and PD have a chain mediating effect between MC and QoL. 231 hematologic tumor patients in a large tertiary hospital were investigated by using Meta-Cognitions Questionnaire-30, Fear of Progression Questionnaire-Short Form, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy scale. Data analyses were performed using IBM SPSS (version 25.0) and the PROCESS macro (version 4.1). The results showed that the direct impact of MC on QoL was not statistically significant. However, the indirect influence of MC on QoL manifest through the independent influences of PD and FoP, as well as the chain mediating effect of "PD → FoP." In addition, all four dimensions of QoL (physical, social and family, emotional, and functional) satisfy the chain mediation model, except for the social and family domain. These insights advance our comprehension of the intricate interplay between MC and QoL, underscoring the importance of improving MC to alleviate patients' PD, mitigate FoP, and ultimately improve the QoL of hematologic tumor patients.
Collapse
Affiliation(s)
- Chunyan Cheng
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Meiqiong Zheng
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Fan Yan
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Yanrong Wu
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Zhengfang Cao
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jiaojiao Yue
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Pan Chen
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Zhongxia Zheng
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Tongfang Fan
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Chunpeng Li
- Intensive Care Medicine Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Panpan Cui
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
- Henan Provincial Intelligent Nursing and Transformation Engineering Research Center, Henan Provincial Key Medicine Laboratory of Nursing, No. 7 Weiwu Road, Zhengzhou, China.
| |
Collapse
|
5
|
Bode M, Kalbe E, Liepelt-Scarfone I. Cognition and Activity of Daily Living Function in people with Parkinson's disease. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02796-w. [PMID: 38976044 DOI: 10.1007/s00702-024-02796-w] [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: 04/12/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024]
Abstract
The ability to perform activities of daily living (ADL) function is a multifaceted construct that reflects functionality in different daily life situations. The loss of ADL function due to cognitive impairment is the core feature for the diagnosis of Parkinson's disease dementia (PDD). In contrast to Alzheimer's disease, ADL impairment in PD can be compromised by various factors, including motor and non-motor aspects. This narrative review summarizes the current state of knowledge on the association of cognition and ADL function in people with PD and introduces the concept of "cognitive ADL" impairment for those problems in everyday life that are associated with cognitive deterioration as their primary cause. Assessment of cognitive ADL impairment is challenging because self-ratings, informant-ratings, and performance-based assessments seldomly differentiate between "cognitive" and "motor" aspects of ADL. ADL function in PD is related to multiple cognitive domains, with attention, executive function, and memory being particularly relevant. Cognitive ADL impairment is characterized by behavioral anomalies such as trial-and-error behavior or task step omissions, and is associated with lower engagement in everyday behaviors, as suggested by physical activity levels and prolonged sedentary behavior. First evidence shows that physical and multi-domain interventions may improve ADL function, in general, but the evidence is confounded by motor aspects. Large multicenter randomized controlled trials with cognitive ADL function as primary outcome are needed to investigate which pharmacological and non-pharmacological interventions can effectively prevent or delay deterioration of cognitive ADL function, and ultimately the progression and conversion to PDD.
Collapse
Affiliation(s)
- Merle Bode
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany
- Medical Faculty, University of Cologne, Cologne, Germany
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
- IB-Hochschule, Stuttgart, Germany.
| |
Collapse
|
6
|
Firouzan F, Sadeghi-Firoozabadi V, Nejati V, Fathabadi J, Firouzan A. A Comparison between the Effectiveness of computerized Cognitive Rehabilitation Training and transcranial Direct Current Stimulation on Dialysis Patients' Executive Functions. Health Psychol Res 2024; 12:118447. [PMID: 38903127 PMCID: PMC11188767 DOI: 10.52965/001c.118447] [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: 02/21/2023] [Accepted: 02/05/2024] [Indexed: 06/22/2024] Open
Abstract
Purpose Executive function impairments are among the most common dialysis side effects. The present study aims to compare the efficiency of transcranial Direct Current Stimulation (tDCS) with computerized Cognitive Rehabilitation Training (cCRT) on dialysis patients' executive functions. Research method The present study, a quasi-experimental effort, adopted a pre-test/post-test method that included a control (sham) group. Design The study sample consisted of 30 participants, selected through the convenience sampling method, and categorized into three groups of cCRT, tDCS, and sham participants. The cCRT participants were asked to complete 8 tasks in Captain's Log MindPower Builder software. The tDCS participants were treated with a 0.06 mA/cm2 current with the anodal electrode on F3 and the cathodal electrode on Fp2. For the sham participants, the electrodes were put on the same regions but there was no current stimulation. The treatment lasted for 10 sessions carried out every other day. Results The results of MANCOVA showed no significant difference between the sham group and the cCRT group in any of the executive function items. . However, between the sham group and the tDCS group was detected a significant difference in spatial working memory (p \< 0.05) and a marginally significant in cognitive flexibility (p = 0.091). No significant difference was reported between cCRT and tDCS groups in any item. Conclusion According to the findings of the study, given the efficacy of tDCS on spatial working memory and cognitive flexibility for dialysis patients, it can be used to improve these skills.
Collapse
Affiliation(s)
- Fatemeh Firouzan
- Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Vahid Sadeghi-Firoozabadi
- Assistant Professor, Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Vahid Nejati
- Professor, Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Jalil Fathabadi
- Associate Professor, Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Ahmad Firouzan
- Associate Professor, Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Bampa G, Moraitou D, Metallidou P, Masoura E, Papantoniou G, Sofologi M, Kougioumtzis GA, Tsolaki M. The Efficacy of a Metacognitive Training Program in Amnestic Mild Cognitive Impairment: A 6-Month Follow-Up Clinical Study. Healthcare (Basel) 2024; 12:1019. [PMID: 38786429 PMCID: PMC11121656 DOI: 10.3390/healthcare12101019] [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: 02/28/2024] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
This study was conducted in response to the increasing prevalence of Alzheimer's disease (AD) dementia and the significant risk faced by individuals with amnestic mild cognitive impairment with multiple-domain deficits (aMCI-md). Given the promising effects of MTPs, the primary aim of this study was to further explore their impact by assessing the maintenance of their benefits. Thus, 45 participants were randomly allocated in two groups: the Experimental group (n = 22), which received the metacognitive training program (MTP), and the Control group (n = 23) that received the cognitive exercises program (CEP). The training programs-the MTP and the CEP-included 10 individual sessions of a one-hour duration and took place once per week. To test the efficacy of the MTP, cognitive and metacognitive outcomes were compared between two groups-Experimental (EG) and Control (CG)-at four distinct time points: before-after-3 months-6 months after intervention. Based on this study's findings, the positive effects of the MTP were evident over a six-month period. Specifically, already three months post-training, the CG began to show a decline in training-related gains. In contrast, the EG's performance consistently improved, highlighting the superior efficacy of the MTP. Gains attributed to the MTP were detected in cognitive measures: cognitive flexibility and immediate visual recall, as well as in metacognitive measures: metacognitive control, improved metacognitive beliefs of attention, and an increased use of cognitive strategies. In conclusion, the results demonstrated the sustained effects of the MTP in cognitive and metacognitive measures over a period of six months, providing novel insight into the application and efficacy of the MTP in individuals with MCI.
Collapse
Affiliation(s)
- Grigoria Bampa
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
| | - Despina Moraitou
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
| | - Panagiota Metallidou
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
| | - Elvira Masoura
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
| | - Georgia Papantoniou
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina (URCI), 45110 Ioannina, Greece
| | - Maria Sofologi
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina (URCI), 45110 Ioannina, Greece
| | - Georgios A. Kougioumtzis
- Department of Turkish and Modern Asian Studies, National and Kapodistrian University of Athens, 15772 Athens, Greece;
- Department of Psychology, Neapolis University Pafos, 8042 Pafos, Cyprus
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
| |
Collapse
|
8
|
Walsh MJ, Dodd MD, Cwiek AP, Hux K, Chiou KS. Metacognitive accuracy predicts self-reported quality of life following traumatic brain injury. Brain Inj 2024; 38:361-367. [PMID: 38329033 DOI: 10.1080/02699052.2024.2311336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Metacognition and quality of life (QoL) are both adversely affected by traumatic brain injury (TBI), but the relation between them is not fully understood. As such, the purpose of this study was to determine the degree to which metacognitive accuracy predicts QoL in individuals with TBI. METHODS Eighteen participants with moderate-to-severe TBI completed a stimulus-response task requiring the discrimination of emotions depicted in pictures of faces and then provided a retrospective confidence judgment after each response. Metacognitive accuracy was calculated using participants' response accuracy and confidence judgment accuracy. Participants also completed the Quality of Life After Brain Injury (QOLIBRI) questionnaire to assess QoL in various areas of functioning. RESULTS Performance of a linear regression analysis revealed that higher metacognitive accuracy significantly predicted lower overall QoL. Additionally, higher metacognitive accuracy significantly predicted lower QoL related to cognition and physical limitations. CONCLUSION The study results provide evidence of an inverse relation between metacognitive performance and QoL following TBI. Metacognitive changes associated with TBI and their relation to QoL have several clinical implications for TBI rehabilitation.
Collapse
Affiliation(s)
- Michael J Walsh
- Department of Psychology and Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Michael D Dodd
- Department of Psychology and Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Andrew P Cwiek
- Department of Psychology, Pennsylvania State University, State College, Pennsylvania, USA
| | - Karen Hux
- Quality Living Inc ., Omaha, Nebraska, USA
| | - Kathy S Chiou
- Department of Psychology and Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| |
Collapse
|
9
|
Shamir D, Loubani K, Schaham NG, Buckman Z, Rand D. Experiences of Older Adults with Mild Cognitive Impairment from Cognitive Self-Training Using Touchscreen Tablets. Games Health J 2024; 13:13-24. [PMID: 37768834 DOI: 10.1089/g4h.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Background: "Tablet Enhancement of Cognition and Health" (TECH) is a cognitive intervention that includes two components: 5 weeks of daily self-training using puzzle-game apps on a touch screen tablet and weekly group sessions. This study aimed to (i) explore experiences of older adults with mild cognitive impairment (MCI) following their participation in TECH, (ii) identify hindering and enabling factors to self-training, and (iii) describe participants' perceived and objective cognitive changes and examine factors associated with their satisfaction from TECH. Materials and Methods: We used quantitative and qualitative measures; a phenomenological qualitative design using focus groups and interviews of 14 older adults with MCI and a focus group of the TECH facilitators. Satisfaction with TECH, self-training time, and perceived and objective cognitive changes (using the Montreal Cognitive Assessment) were evaluated. Results: Qualitative data were classified into three categories: Memory problems, Hindering and enabling factors to self-training, and Meaningful group sessions. The TECH facilitators reported positive changes, less cognitive complaints, and commitment and satisfaction of the participants. Participants reported overall satisfaction from TECH and performed a median interquartile range of 22.6 (19.9-42.8) self-training hours. Higher satisfaction was correlated with a higher objective cognitive change (r = 0.95, P < 0.01) and less training time (r = -0.91, P < 0.01). Discussion and Conclusions: Participants in the current study actively engaged in daily self-training using touch screen-tablet-puzzle-game and functional apps, driven by both internal and external motivators. Despite the lack of cognitive improvement, they expressed satisfaction with their participation in TECH. Therefore, encouraging older adults to engage in meaningful cognitive stimulating activities is recommended.
Collapse
Affiliation(s)
- Dafna Shamir
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Khawla Loubani
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Givon Schaham
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Buckman
- Maccabi-Healthcare Services, Rishon L'Zion, Israel
| | - Debbie Rand
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
10
|
Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [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: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
Collapse
Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
| |
Collapse
|
11
|
Pépin M, Klimkowicz-Mrowiec A, Godefroy O, Delgado P, Carriazo S, Ferreira AC, Golenia A, Malyszko J, Grodzicki T, Giannakou K, Paolisso G, Barbieri M, Garneata L, Mocanu CA, Liabeuf S, Spasovski G, Zoccali C, Bruchfeld A, Farinha A, Arici M, Capasso G, Wiecek A, Massy ZA. Cognitive disorders in patients with chronic kidney disease: Approaches to prevention and treatment. Eur J Neurol 2023; 30:2899-2911. [PMID: 37326125 DOI: 10.1111/ene.15928] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cognitive impairment is common in patients with chronic kidney disease (CKD), and early intervention may prevent the progression of this condition. METHODS Here, we review interventions for the complications of CKD (anemia, secondary hyperparathyroidism, metabolic acidosis, harmful effects of dialysis, the accumulation of uremic toxins) and for prevention of vascular events, interventions that may potentially be protective against cognitive impairment. Furthermore, we discuss nonpharmacological and pharmacological methods to prevent cognitive impairment and/or minimize the latter's impact on CKD patients' daily lives. RESULTS A particular attention on kidney function assessment is suggested during work-up for cognitive impairment. Different approaches are promising to reduce cognitive burden in patients with CKD but the availabe dedicated data are scarce. CONCLUSIONS There is a need for studies assessing the effect of interventions on the cognitive function of patients with CKD.
Collapse
Affiliation(s)
- Marion Pépin
- INSERM (Institut National de la Santé et de la recherche médicale) Unit 1018, Clinical Epidemiology, CESP (Centre d'Epidemiologie et de Santé des Populations), Hôpital Paul Brousse, Paris-Saclay University and Versailles Saint-Quentin-en-Yvelines University, Villejuif, France
- Department of Geriatrics, Ambroise Paré University Hospital, APHP (Assistance Publique - Hôpitaux de Paris), Boulogne-Billancourt/Paris, France
| | | | - Olivier Godefroy
- Department of Neurology, Amiens University Hospital, and Laboratory of Functional Neurosciences (Research Unit 4559), Jules Verne University of Picardie (UPJV), Amiens, France
| | - Pilar Delgado
- Department of Neurology, Vall d'Hebron Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Sol Carriazo
- Department of Nephrology and Hypertension, Instituto de Investigacion Sanitaria (IIS)-Fundacion Jimenez Diaz, Autonomous University of Madrid (UAM), Madrid, Spain
| | - Ana Carina Ferreira
- Department of Nephrology, Centro Hospitalar e Universitário de Lisboa Central-Hospital Curry Cabral, Lisbon, Portugal
- Universidade Nova de Lisboa-Faculdade de Ciências Médicas-Nephology, Lisbon, Portugal
| | | | - Jolanta Malyszko
- Department of Nephrology, Dialysis, and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Cracow, Poland
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
- UniCAMILLUS, International Medical University, Roma, Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Liliana Garneata
- Department of Internal Medicine and Nephrology, "Carol Davila" University of Medicine and Pharmacy, "Dr Carol Davila" Teaching Hospital of Nephrology, Bucharest, Romania
| | - Carmen Antonia Mocanu
- Department of Internal Medicine and Nephrology, "Carol Davila" University of Medicine and Pharmacy, "Dr Carol Davila" Teaching Hospital of Nephrology, Bucharest, Romania
| | - Sophie Liabeuf
- Pharmacology Department, Amiens University Medical Center, Amiens, France
- MP3CV (Mécanismes physiopathologiques et Conséquences des Calcifications Cardio-Vasculaires) Laboratory, EA7517, University of Picardie Jules Verne, Amiens, France
| | - Goce Spasovski
- University Department of Nephrology, Clinical Center "Mother Theresa", University of Saints Cyril and Methodius, Skopje, North Macedonia
| | - Carmine Zoccali
- Renal Research Institute, New York, New York, USA
- Associazione Ipertensione Nefrologia Trapianto Renale, Reggio Calabria, Italy
| | - Annette Bruchfeld
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
- CLINTEC, Renal Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Ana Farinha
- Department of Nephrology, Centro Hospitalar de Setúbal, Setubal, Portugal
| | - Mustafa Arici
- Department of Internal Medicine, Division of Nephrology, Hacetepe University, Faculty of Medicine, Ankara, Turkey
| | - Giovambattista Capasso
- Biogem (Molecular Biology and Genetics Research Institute), Ariano Irpino, Italy
- Department of Translational Medical Sciences, University of Campania, Naples, Italy
| | - Andrzej Wiecek
- Department of Nephrology, Transplantation, and Internal Medicine, Medical University of Silesia in Katowice, Katowice, Poland
| | - Ziad A Massy
- INSERM (Institut National de la Santé et de la recherche médicale) Unit 1018, Clinical Epidemiology, CESP (Centre d'Epidemiologie et de Santé des Populations), Hôpital Paul Brousse, Paris-Saclay University and Versailles Saint-Quentin-en-Yvelines University, Villejuif, France
- Department of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt/Paris, France
| |
Collapse
|
12
|
Tulliani N, Bye R, Bissett M, Coutts S, Liu KPY. A Semantic-Based Cognitive Training Programme on Everyday Activities: A Feasibility and Acceptability Study among Cognitively Healthy Older Adults. Occup Ther Int 2023; 2023:2153223. [PMID: 37664163 PMCID: PMC10468288 DOI: 10.1155/2023/2153223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023] Open
Abstract
Background During the normal ageing process, a person's cognitive functions and memory gradually decline, which can affect their ability to perform everyday activities including cooking, cleaning, managing finances, and shopping. Semantic memory encoding strategies benefit older adults' cognitive and functional performance. Such strategies can be taught by an accessible, cost-effective, and flexible app-based programme. Currently, no studies examine such an app-based programme focussed on everyday activities. Objectives To determine if an app-based programme constructed on the principles of semantic memory encoding strategies, targeted towards older adults, called Enhancing Memory in Daily Life (E-MinD Life) is (1) feasible by examining acceptance, engagement, and attendance and (2) acceptable by examining the perceived effectiveness, relevancy, clarity, and convenience. Methods Eleven participants were recruited to a nine-week (18 sessions) programme using E-MinD Life. Feasibility was measured by collecting data on recruitment and retention rates, attendance, and duration of sessions. Acceptability was measured via a Likert scale questionnaire and free comments. Likert scale responses were analysed using descriptive statistics; open-ended responses were categorised qualitatively via constant comparative approach. Results Nine participants completed the programme. Overall, most participants found the programme relevant, convenient, logical, and easy to understand and perceived it to be effective to address functional cognitive problems impacting performance of everyday activities. The results from the qualitative analysis showed that participants found the programme enjoyable and the interaction with the research team throughout the intervention beneficial. Conclusion E-MinD Life shows promise as the focus of further research to determine the effectiveness of the programme and sematic-based cognitive strategies in maintaining cognition and performance in everyday activities among older adults with and without cognitive impairment.
Collapse
Affiliation(s)
- Nikki Tulliani
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Michelle Bissett
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Samantha Coutts
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Karen P. Y. Liu
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| |
Collapse
|
13
|
De Wit L, Levy SA, Kurasz AM, Amofa P, DeFeis B, O'Shea D, Chandler MJ, Smith GE. Procedural learning, declarative learning, and working memory as predictors of learning the use of a memory compensation tool in persons with amnestic mild cognitive impairment. Neuropsychol Rehabil 2023; 33:1278-1303. [PMID: 35749375 DOI: 10.1080/09602011.2022.2089697] [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: 09/11/2021] [Accepted: 06/09/2022] [Indexed: 09/30/2022]
Abstract
Persons with amnestic Mild Cognitive Impairment (aMCI) are at risk for experiencing changes in their daily functioning due to their memory impairment. The Memory Support System (MSS), a compensatory calendaring system, was developed to support functional independence in persons with aMCI (pwaMCI). This cross-sectional study examined procedural learning, declarative learning, and working memory as predictors of MSS learning efficiency in pwaMCI. Sixty pwaMCI participated in MSS training. The Serial Reaction Time Test and Mirror Tracing Test were used to assess procedural learning. The Rey Auditory Verbal Learning Test and CogState One Card Learning were used to assess declarative learning and the CogState One Back task was used to assess working memory. Multiple regression analyses were conducted to assess if procedural learning, declarative learning, and working memory predicted MSS learning efficiency. This study showed that declarative learning predicted MSS learning efficiency in pwaMCI, with less consistent results for procedural learning and non-significant results for working memory. Findings suggest that success in teaching compensatory tools is greater when training is offered in early aMCI before declarative learning skill is fully lost. Future studies should assess additional strategies to facilitate MSS learning in advanced aMCI.
Collapse
Affiliation(s)
- Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Shellie-Anne Levy
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea M Kurasz
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Priscilla Amofa
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Brittany DeFeis
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Deirdre O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Melanie J Chandler
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Glenn E Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| |
Collapse
|
14
|
Tulliani N, Bye R, Bissett M, Coutts S, Liu KPY. The feasibility and acceptability of an app-based cognitive strategy training programme for older people. Pilot Feasibility Stud 2023; 9:109. [PMID: 37391842 DOI: 10.1186/s40814-023-01334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/07/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Increasing numbers of people are living with mild cognitive impairment in later life and seeking therapy to maintain cognition to remain as independent as possible in daily life. Based on a review of the literature, an app-based programme using perceptual-encoding strategies called Enhancing Memory in Daily Life (E-MinD Life) was developed. An expert panel reviewed the programme's appropriateness for older people with and without mild cognitive impairment. As part of the design process, the feasibility and acceptability of the E-MinD Life programme were then assessed in relation to its use by healthy older adults, with findings informing the application of the programme to older people with mild cognitive impairment in the future. METHODS Phase 1: The E-MinD Life programme was reviewed by an expert panel of occupational therapists. Experts rated the programme on a Likert scale and answered open-ended questions in relation to feasibility, clarity, and relevancy. Phase 2 involved field-testing the 9-week programme with a sample of nine healthy older people. Participants rated the acceptability of the programme on a Likert scale questionnaire. Data on recruitment rates and retention, and adherence and duration of sessions were collected to determine the feasibility of the programme. Responses to the Likert scale were analysed using descriptive statistics. Open-ended responses were categorised qualitatively using a constant comparative approach. RESULTS Phase 1: Experts indicated that the E-MinD Life programme was feasible and included relevant activities for community living. Although experts felt that an older user with mild NCD would be able to independently complete the programme, the qualitative analysis suggests formatting changes in future iterations of the programme to enhance visual clarity. Phase 2: All participants completed the 9-week programme. The average number of self-administered sessions attempted over the 9-week period was 13.44 (SD = 6.73) out of 18 scheduled sessions. Overall, most participants found the programme relevant, logical and easy to understand, and perceived it to be effective for functional cognitive problems. CONCLUSION The E-MinD Life programme shows promise for inclusion into trial designs to determine the effectiveness of the cognitive strategy programme for older people with and without cognitive impairment. TRIAL REGISTRATION ClinicalTrials.gov, NCT03430401. Registered 1 February 2018.
Collapse
Affiliation(s)
- Nikki Tulliani
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia.
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
| | - Michelle Bissett
- Faculty of Health, Southern Cross University, QLD, Gold Coast, Australia
| | - Samantha Coutts
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
- Translation Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| |
Collapse
|
15
|
Zhao X, Ji C, Zhang C, Huang C, Zhou Y, Wang L. Transferability and sustainability of process-based multi-task adaptive cognitive training in community-dwelling older adults with mild cognitive impairment: a randomized controlled trial. BMC Psychiatry 2023; 23:418. [PMID: 37308857 PMCID: PMC10259063 DOI: 10.1186/s12888-023-04917-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Cognitive training shows promising effects for improving cognitive domains in individuals with mild cognitive impairment (MCI), including the crucial predictive factor of executive function (EF) for dementia prognosis. Few studies have paid sufficient emphasis on the training-induced effects of cognitive training programs, particularly with regards to targeting EF. A process-based multi-task adaptive cognitive training (P-bM-tACT) program targeting EF is required to examine direct, transfer, and sustainability effects in older adults with MCI. OBJECTIVE This study aimed to evaluate the direct effects of a P-bM-tACT program on EF, the transfer effects on untrained cognitive domains, and further explore the sustainability of training gains for older adults with MCI in the community. METHODS In a single-blind, randomized controlled trial, 92 participants with MCI were randomly assigned to either the intervention group, participating in a P-bM-tACT program (3 training sessions/week, 60 min/session for 10 weeks) or the wait-list control group, accepting a health education program on MCI (1 education session/ twice a week, 40-60 min/session for 10 weeks). The direct and transfer effects of the P-bM-tACT program were assessed at baseline, immediately after 10 weeks of training, and the 3-month follow-up. Repeated measures analysis of variance and a simple effect test were used to compare the direct and transfer effects over the 3-time points between the two groups. RESULTS The P-bM-tACT program yielded a greater benefit of direct and transfer effects in the intervention group participants than in the wait-list control group. Combined with the results of simple effect tests, the direct and transfer effects of participants in the intervention group significantly increased immediately after 10 weeks of training compared to the baseline (F = 14.702 ~ 62.905, p < 0.05), and these effects were maintained at the 3-month follow-up (F = 19.595 ~ 122.22, p < 0.05). Besides, the acceptability of the cognitive training program was established with a high adherence rate of 83.4%. CONCLUSIONS The P-bM-tACT program exerted positive direct and transfer effects on the improvement of cognitive function, and these effects were sustained for 3 months. The findings provided a viable and potential approach to improving cognitive function in older adults with MCI in the community. TRIAL REGISTRATION The trial was registered at Chinese Clinical Trials Registry on 09/01/2019 ( www.chictr.org.cn ; Number Registry: ChiCTR1900020585).
Collapse
Affiliation(s)
- Xia Zhao
- Department of Geriatric Psychiatry, Suzhou Guangji Hospital, JiangSu, China
- School of Medicine, Huzhou University, Zhejiang, China
| | - Caifang Ji
- Department of Geriatric Psychiatry, Suzhou Guangji Hospital, JiangSu, China
| | - Chen Zhang
- Department of general medicine, Community health service center of Binhu Street, Zhejiang, China
| | - Cheng Huang
- School of Medicine, Huzhou University, Zhejiang, China
| | - Yuanyuan Zhou
- School of Nursing, Jiangsu College of Nursing, JiangSu, China
| | - Lina Wang
- School of Medicine, Huzhou University, Zhejiang, China.
| |
Collapse
|
16
|
Bugallo-Carrera C, Facal D, Domínguez-Lenogue C, Álvarez-Vidal V, Gandoy-Crego M, Caamaño-Ponte J. Neuropsychiatric Symptoms after Liver Transplantation in a 65-Year-Old Male Patient. Brain Sci 2022; 12:1721. [PMID: 36552180 PMCID: PMC9776108 DOI: 10.3390/brainsci12121721] [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: 11/05/2022] [Revised: 12/07/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
The development of immunosuppressants has been key for the advancement of solid organ transplant surgery. Specifically, cyclosporine, tacrolimus, or everolimus have significantly increased the survival rate of patients by reducing the risk of a rejection of the transplanted organ and limiting graft-versus-host disease. We report the case of a 65-year-old man who, after undergoing a liver transplantation and receiving an immunosuppressive treatment with cyclosporine and everolimus, presented severe obsessive, psychotic, and behavioral symptoms over the past three years, and describe the pharmacological and non-pharmacological interventions implemented against these symptoms. In this case, the immunosuppressants used have been cyclosporine and, preferably, everolimus. On the other hand, potential adverse reactions to the treatment have been observed, including neuropsychiatric symptoms such as tremor, anxiety, dysthymia, psychosis, and behavioral disorders, which make it necessary to use corrective psychoactive drugs such as benzodiazepines, antidepressants, and antipsychotics, combined with non-pharmacological interventions. A transversal approach, from the medical and psychosocial disciplines, facilitates success in managing neuropsychiatric symptoms after soft organ transplants.
Collapse
Affiliation(s)
- Cesar Bugallo-Carrera
- Asociación de Familiares de Enfermos de Alzheimer de Fisterra e Soneira—Afafes. Cee, 15270 A Coruña, Spain
- Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - David Facal
- Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Cristina Domínguez-Lenogue
- Asociación de Familiares de Enfermos de Alzheimer de Fisterra e Soneira—Afafes. Cee, 15270 A Coruña, Spain
| | - Vanessa Álvarez-Vidal
- Hospital de Día de Procesos, Servicio de Geriatría, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain
| | - Manuel Gandoy-Crego
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | | |
Collapse
|
17
|
Li B, Ji S, Peng A, Yang N, Zhao X, Feng P, Zhang Y, Chen L. Development of a Gastrointestinal-Myoelectrical-Activity-Based Nomogram Model for Predicting the Risk of Mild Cognitive Impairment. Biomolecules 2022; 12:biom12121861. [PMID: 36551289 PMCID: PMC9775682 DOI: 10.3390/biom12121861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Mild cognitive impairment (MCI) is the prodromal stage and an important risk factor of Alzheimer's disease (AD). Interventions at the MCI stage are significant in reducing the occurrence of AD. However, there are still many obstacles to the screening of MCI, resulting in a large number of patients going undetected. Given the strong correlation between gastrointestinal function and neuropsychiatric disorders, the aim of this study is to develop a risk prediction model for MCI based on gastrointestinal myoelectrical activity. The Mini-Mental State Examination and electrogastroenterography were applied to 886 participants in western China. All participants were randomly assigned to the training and validation sets in a ratio of 7:3. In the training set, risk variables were screened using LASSO regression and logistic regression, and risk prediction models were built based on nomogram and decision curve analysis, then validation was performed. Eight predictors were selected in the training set, including four electrogastroenterography parameters (rhythm disturbance, dominant frequency and dominant power ratio of gastric channel after meal, and time difference of intestinal channel after meal). The area under the ROC curve for the prediction model was 0.74 in the training set and 0.75 in the validation set, both of which exhibited great prediction ability. Furthermore, decision curve analysis displayed that the net benefit was more desirable when the risk thresholds ranged from 15% to 35%, indicating that the nomogram was clinically usable. The model based on gastrointestinal myoelectrical activity has great significance in predicting the risk of MCI and is expected to be an alternative to scales assessment.
Collapse
Affiliation(s)
- Baichuan Li
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu 610044, China
| | - Shuming Ji
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610044, China
| | - Anjiao Peng
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu 610044, China
| | - Na Yang
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610044, China
| | - Xia Zhao
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610044, China
| | - Peimin Feng
- Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610044, China
| | - Yunwu Zhang
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Lei Chen
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu 610044, China
- Correspondence:
| |
Collapse
|
18
|
Khayoun R, Devick KL, Chandler MJ, Shandera-Ochsner AL, De Wit L, Cuc A, Smith GE, Locke DEC. The impact of patient and partner personality traits on learning success for a cognitive rehabilitation intervention for patients with MCI. Neuropsychol Rehabil 2022; 32:2483-2495. [PMID: 34232113 DOI: 10.1080/09602011.2021.1948872] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Memory Support System (MSS) is the memory compensation tool used in the HABIT Healthy Action to Benefit Independence and Thinking® Program. People diagnosed with mild cognitive impairment (pwMCI; n = 153) participated in this cognitive rehabilitative programme with a partner. We first aimed to determine if prior research on the positive impact of higher baseline cognitive status on successful MSS learning would be replicated in a new sample. We further evaluated the impact of the pwMCI's and partner's personality traits, as measured by the Ten Item Personality Inventory, on successful learning. Better global cognitive status was again shown to increase the odds for MSS learning success. In terms of personality, the highest odds of learning success occurred when the pwMCI was high in Openness to Experience (OR = 5.43), followed by high partner Openness (OR = 2.53) or high Openness in both the pwMCI and partner (OR = 2.31). In sum, when the pwMCI possessed both better cognitive status and openness to new experience they were better able to master a cognitive rehabilitation tool for MCI.
Collapse
Affiliation(s)
- Renata Khayoun
- Mayo Clinic Arizona, Division of Neuropsychology, Scottsdale, AZ, USA
| | - Katrina L Devick
- Mayo Clinic Arizona, Department of Quantitative Health Sciences, Scottsdale, AZ, USA
| | - Melanie J Chandler
- Mayo Clinic Florida, Department of Psychiatry and Psychology, Jacksonville, FL, USA
| | | | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea Cuc
- Mayo Clinic Arizona, Division of Neuropsychology, Scottsdale, AZ, USA
| | - Glenn E Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Dona E C Locke
- Mayo Clinic Arizona, Division of Neuropsychology, Scottsdale, AZ, USA
| |
Collapse
|
19
|
Brill E, Krebs C, Falkner M, Peter J, Henke K, Züst M, Minkova L, Brem AK, Klöppel S. Can a serious game-based cognitive training attenuate cognitive decline related to Alzheimer's disease? Protocol for a randomized controlled trial. BMC Psychiatry 2022; 22:552. [PMID: 35962371 PMCID: PMC9373273 DOI: 10.1186/s12888-022-04131-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a major public health issue. Cognitive interventions such as computerized cognitive trainings (CCT) are effective in attenuating cognitive decline in AD. However, in those at risk of dementia related to AD, results are heterogeneous. Efficacy and feasibility of CCT needs to be explored in depth. Moreover, underlying mechanisms of CCT effects on the three cognitive domains typically affected by AD (episodic memory, semantic memory and spatial abilities) remain poorly understood. METHODS In this bi-centric, randomized controlled trial (RCT) with parallel groups, participants (planned N = 162, aged 60-85 years) at risk for AD and with at least subjective cognitive decline will be randomized to one of three groups. We will compare serious game-based CCT against a passive wait list control condition and an active control condition (watching documentaries). Training will consist of daily at-home sessions for 10 weeks (50 sessions) and weekly on-site group meetings. Subsequently, the CCT group will continue at-home training for an additional twenty-weeks including monthly on-site booster sessions. Investigators conducting the cognitive assessments will be blinded. Group leaders will be aware of participants' group allocations. Primarily, we will evaluate change using a compound value derived from the comprehensive cognitive assessment for each of three cognitive domains. Secondary, longitudinal functional and structural magnetic resonance imaging (MRI) and evaluation of blood-based biomarkers will serve to investigate neuronal underpinnings of expected training benefits. DISCUSSION The present study will address several shortcomings of previous CCT studies. This entails a comparison of serious game-based CCT with both a passive and an active control condition while including social elements crucial for training success and adherence, the combination of at-home and on-site training, inclusion of booster sessions and assessment of physiological markers. Study outcomes will provide information on feasibility and efficacy of serious game-based CCT in older adults at risk for AD and will potentially generalize to treatment guidelines. Moreover, we set out to investigate physiological underpinnings of CCT induced neuronal changes to form the grounds for future individually tailored interventions and neuro-biologically informed trainings. TRIAL REGISTRATION This RCT was registered 1st of July 2020 at clinicaltrials.gov (Identifier NCT04452864).
Collapse
Affiliation(s)
- Esther Brill
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Christine Krebs
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Michael Falkner
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Jessica Peter
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Katharina Henke
- Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Marc Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lora Minkova
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| |
Collapse
|
20
|
Pike K, Moller CI, Bryant C, Farrow M, Dao DP, Ellis KA. Examination of the Feasibility, Acceptability, and Efficacy of the Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) Program for Older Adults: Results from a Single-Arm Pre-Post Trial (Preprint). J Med Internet Res 2022; 25:e41712. [PMID: 37079356 PMCID: PMC10160943 DOI: 10.2196/41712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/14/2023] [Accepted: 02/27/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Memory strategy training for older adults helps maintain and improve cognitive health but is traditionally offered face-to-face, which is resource intensive, limits accessibility, and is challenging during a pandemic. Web-based interventions, such as the Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) program, may overcome such barriers. OBJECTIVE We report on OPTIMiSE's feasibility, acceptability, and efficacy. METHODS Australians aged ≥60 years reporting subjective cognitive decline participated in this single-arm pre-post web-based intervention. OPTIMiSE is a 6-module web-based program offered over 8-weeks with a 3-month booster. It has a problem-solving approach to memory issues, focusing on psychoeducation about memory and aging, knowledge and practice of compensatory memory strategies, and personalized content related to individual priorities. We examined the feasibility (recruitment, attrition, and data collection), acceptability (recommendation to others, suggestions for improvement, and withdrawal reasons), and efficacy (change in goal satisfaction, strategy knowledge and use, self-reported memory, memory satisfaction and knowledge, and mood; thematic content analysis of the most significant change; and the application of knowledge and strategies in daily life) of OPTIMiSE. RESULTS OPTIMiSE was feasible, demonstrated by strong interest (633 individuals screened), a satisfactory level of attrition (158/312, 50.6%), and minimal missing data from those completing the intervention. It was acceptable, with 97.4% (150/154) of participants agreeing they would recommend OPTIMiSE, the main suggestion for improvement being more time to complete modules, and withdrawal reasons similar to those in in-person interventions. OPTIMiSE was also efficacious, with linear mixed-effects analyses revealing improvements, of moderate to large effect sizes, across all primary outcomes (all P<.001): memory goal satisfaction (Cohen d after course=1.24; Cohen d at 3-month booster=1.64), strategy knowledge (Cohen d after course=0.67; Cohen d at 3-month booster=0.72) and use (Cohen d after course=0.79; Cohen d at 3-month booster=0.90), self-reported memory (Cohen d after course=0.80; Cohen d at 3-month booster=0.83), memory satisfaction (Cohen d after course=1.25; Cohen d at 3-month booster=1.29) and knowledge (Cohen d after course=0.96; Cohen d at 3-month booster=0.26), and mood (Cohen d after course=-0.35; nonsignificant Cohen d at booster). Furthermore, the most significant changes reported by participants (strategy use, improvements in daily life, reduced concern about memory, confidence and self-efficacy, and sharing and shame busting with others) reflected the course objectives and were consistent with themes arising from previous in-person interventions. At the 3-month booster, many participants reported continued implementation of knowledge and strategies in their daily lives. CONCLUSIONS This feasible, acceptable, and efficacious web-based program has the potential to enable access to evidence-based memory interventions for older adults worldwide. Notably, the changes in knowledge, beliefs, and strategy use continued beyond the initial program. This is particularly important for supporting the growing number of older adults living with cognitive concerns. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620000979954; https://tinyurl.com/34cdantv. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.3233/ADR-200251.
Collapse
Affiliation(s)
- Kerryn Pike
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, Australia
- School of Applied Psychology, Griffith Centre for Mental Health & Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Carl I Moller
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Maree Farrow
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Duy P Dao
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Kathryn A Ellis
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
21
|
Kim H, Lee J, Man Chang S, Kim BS. Effects of a cognitive rehabilitation program based on mnemonic skills and memory compensatory strategies for older adults: A pilot study. Medicine (Baltimore) 2022; 101:e29581. [PMID: 35945795 PMCID: PMC9351895 DOI: 10.1097/md.0000000000029581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND With the aging of the population, the number of people with age-related memory complaints has also increased. The purpose of this study was to develop a cognitive rehabilitation program based on mnemonic skills and memory compensatory strategies (CRM) and to investigate the effects of CRM in community-dwelling older adults without dementia. METHODS This study was an open-label, single-arm, pilot study. We developed a CRM program comprising 8 weekly sessions. The study participants consisted of older adults with normal cognitive function and mild cognitive impairment (MCI). They were recruited from eight dementia counseling centers and one senior welfare center. To assess the effects of CRM, we administered the following tests at baseline and after completion of the program: Subjective Memory Complaints Questionnaire, the Short form of Geriatric Depression Scale, the Euro Quality of life-5 Dimension, and the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery. RESULTS Thirty-two participants completed the study. Among older adults with normal cognitive function, CRM showed significant improvement in verbal memory function. Among the older adults with MCI, CRM showed significant improvements in language ability, verbal recognition memory, nonverbal memory, attention, and processing speed. CONCLUSION CRM improved cognitive function in two distinct populations, older adults with normal cognitive function and older adults with MCI. Additionally, our preliminary findings suggest that older adults with MCI show cognitive improvement in both the trained and non-trained cognitive domains.
Collapse
Affiliation(s)
- Hyerim Kim
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, South Korea
| | - Jimin Lee
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, South Korea
| | - Sung Man Chang
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, South Korea
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Byung-Soo Kim
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, South Korea
- Department of Psychiatry, Kyungpook National University Chilgok Hospital, Daegu, South Korea
- *Correspondence: Byung-Soo Kim, Department of Psychiatry, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu 41404, South Korea (e-mail: )
| |
Collapse
|
22
|
Duran T, Woo E, Otero D, Risacher SL, Stage E, Sanjay AB, Nho K, West JD, Phillips ML, Goukasian N, Hwang KS, Apostolova LG. Associations between Cortical Thickness and Metamemory in Alzheimer's Disease. Brain Imaging Behav 2022; 16:1495-1503. [PMID: 35064438 PMCID: PMC9450553 DOI: 10.1007/s11682-021-00627-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 12/27/2022]
Abstract
Metacognitive deficits affect Alzheimer's disease (AD) patient safety and increase caregiver burden. The brain areas that support metacognition are not well understood. 112 participants from the Imaging and Genetic Biomarkers for AD (ImaGene) study underwent comprehensive cognitive testing and brain magnetic resonance imaging. A performance-prediction paradigm was used to evaluate metacognitive abilities for California Verbal Learning Test-II learning (CVLT-II 1-5) and delayed recall (CVLT-II DR); Visual Reproduction-I immediate recall (VR-I Copy) and Visual Reproduction-II delayed recall (VR-II DR); Rey-Osterrieth Complex Figure Copy (Rey-O Copy) and delayed recall (Rey-O DR). Vertex-wise multivariable regression of cortical thickness was performed using metacognitive scores as predictors while controlling for age, sex, education, and intracranial volume. Subjects who overestimated CVLT-II DR in prediction showed cortical atrophy, most pronounced in the bilateral temporal and left greater than right (L > R) frontal cortices. Overestimation of CVLT-II 1-5 prediction and DR performance in postdiction showed L > R associations with medial, inferior and lateral temporal and left posterior cingulate cortical atrophy. Overconfident prediction of VR-I Copy performance was associated with right greater than left medial, inferior and lateral temporal, lateral parietal, anterior and posterior cingulate and lateral frontal cortical atrophy. Underestimation of Rey-O Copy performance in prediction was associated with atrophy localizing to the temporal and cingulate areas, and in postdiction, with diffuse cortical atrophy. Impaired metacognition was associated to cortical atrophy. Our results indicate that poor insight into one's cognitive abilities is a pervasive neurodegenerative feature associated with AD across the cognitive spectrum.
Collapse
Affiliation(s)
- Tugce Duran
- Department of Internal Medicine-Section of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, 525 Vine Street, Suite 150, Winston-Salem, NC, 27101, USA.
| | - Ellen Woo
- Department of Psychology, California State University, Fresno, Fresno, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Diana Otero
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shannon L Risacher
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eddie Stage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Apoorva B Sanjay
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kwangsik Nho
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John D West
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Meredith L Phillips
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Naira Goukasian
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Kristy S Hwang
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Liana G Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
23
|
Li F, Parsons J, Peri K, Yu A, Cheung G. Effects of cognitive interventions on quality of life among adults with mild cognitive impairment: A systematic review and meta-analysis of randomised controlled trials. Geriatr Nurs 2022; 47:23-34. [PMID: 35816984 DOI: 10.1016/j.gerinurse.2022.06.009] [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: 04/17/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is considerable research exploring the impact of cognitive interventions on cognition in people with mild cognitive impairment (MCI). However, the impact on quality of life (QOL) is not routinely reported. As QOL is a key predictor of health outcomes, it is important to determine the evidence supporting cognitive interventions for improving QOL in people with MCI. OBJECTIVE To evaluate the evidence on the effectiveness of cognitive interventions for improving QOL among people with MCI. DESIGN Systematic review and meta-analysis. METHODS A systematic database search was conducted from inception to December 11, 2021, using four databases. Quality assessment was conducted, and data on the characteristics of the studies and the effects on QOL were extracted. Subgroup analyses and meta-regression were conducted to elucidate the effects of potential moderator variables on QOL measures. RESULTS Of the 1550 records initially identified, 17 studies met the criteria for the final meta-analysis. The findings revealed that cognitive interventions produced moderate gains in overall QOL compared to the control group at the posttest (standardized mean difference (SMD): 0.53, 95% confidence interval (CI): [0.23, 0.84]), but no statistically significant differences were found at the end of follow-up (SMD: 0.40, 95% CI: [-0.15,0.94]). Furthermore, the effects of cognitive interventions were moderated by intervention duration, session duration, and study location. However, intervention types, session frequency, intervention components, control condition, total number of sessions, types of QOL measures, and responders to QOL-AD had no statistically significant effects on QOL outcome. CONCLUSIONS Cognitive interventions have positive effects on QOL among adults with MCI. However, the high heterogeneity of the included studies calls for more well-designed cognitive intervention trials to examine the association between QOL and relevant moderators.
Collapse
Affiliation(s)
- Fei Li
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Level 2, Building 505, 85 Park Road, Grafton, Auckland 1142, New Zealand; School of Nursing, Guangxi Medical University, Guangxi, China.
| | - John Parsons
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Level 2, Building 505, 85 Park Road, Grafton, Auckland 1142, New Zealand
| | - Kathy Peri
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Level 2, Building 505, 85 Park Road, Grafton, Auckland 1142, New Zealand
| | - An Yu
- Te Huataki Waiora School of Health, Division of Health, Engineering, Computing & Science, The University of Waikato, Hamilton, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|
24
|
Kognitive Interventionen bei der Alzheimer-Krankheit. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022; 90:344-351. [PMID: 35858612 DOI: 10.1055/a-1869-4377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Cognitive interventions (CI) are an important part in the treatment of Alzheimer's disease (AD). These non-pharamcological treatment options are manifold and can be matched to a patient's particular symptoms and needs. This article gives an overview of CIs and their theoretical background, as well as empirical evidence concerning their efficacy at different stages of the disease. Specific determinants of their effectiveness and possible clinical applications are discussed, while also recent developments, such as computer-based CIs, are considered.
Collapse
|
25
|
Scheerbaum P, Book S, Jank M, Hanslian E, DellO'ro M, Schneider J, Scheuermann JS, Bösl S, Jeitler M, Kessler C, Graessel E. Computerised cognitive training tools and online nutritional group counselling for people with mild cognitive impairment: study protocol of a completely digital, randomised, controlled trial. BMJ Open 2022; 12:e060473. [PMID: 35777882 PMCID: PMC9252202 DOI: 10.1136/bmjopen-2021-060473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION People with mild cognitive impairment (MCI) are at increased risk of decreasing cognitive functioning. Computerised cognitive training (CCT) and nutrition have been shown to improve the cognitive capacities of people with MCI. For each variable, we developed two kinds of interventions specialised for people with MCI (CCT: 'individualised' CCT; nutrition: a whole-food, plant-based diet). Additionally, there are two kinds of active control measures (CCT: 'basic' CCT; nutrition: a healthy diet following the current guidelines of the German Nutrition Society). The aim of this study is to investigate the effects of the two interventions on cognition in people with MCI in a 2×2 randomised controlled trial with German participants. METHODS AND ANALYSIS Participants will be community-dwelling individuals with a psychometric diagnosis of MCI based on the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination. With N=200, effects with an effect size of f≥0.24 (comparable to Cohen's d≥0.48) can be detected. Screening, baseline, t6 and t12 testing will be conducted via a videoconferencing assessment, telephone, and online survey. Participants will be randomly allocated to one of four groups and will receive a combination of CCT and online nutritional counselling. The CCT can be carried out independently at home on a computer, laptop, or tablet. Nutrition counselling includes 12 online group sessions every fortnight for 1.5 hours. The treatment phase is 6 months with follow-ups after six and 12 months after baseline. ETHICS AND DISSEMINATION All procedures were approved by the Friedrich-Alexander-Universität Erlangen-Nürnberg Ethics Committee (Ref. 21-318-1-B). Written informed consent will be obtained from all participants. Results will be published in peer-reviewed scientific journals, conference presentations. TRIAL REGISTRATION NUMBER ISRCTN10560738.
Collapse
Affiliation(s)
- Petra Scheerbaum
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephanie Book
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Jank
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Genesis Mediware GmbH, Hersbruck, Germany
| | - Etienne Hanslian
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Melanie DellO'ro
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Julia Schneider
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Julia-Sophia Scheuermann
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sophia Bösl
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Christian Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Elmar Graessel
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
26
|
Book S, Jank M, Pendergrass A, Graessel E. Individualised computerised cognitive training for community-dwelling people with mild cognitive impairment: study protocol of a completely virtual, randomised, controlled trial. Trials 2022; 23:371. [PMID: 35513855 PMCID: PMC9069424 DOI: 10.1186/s13063-022-06152-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 03/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background People with mild cognitive impairment (MCI) are at increased risk of converting to dementia. Cognitive training can improve the cognitive abilities of people with MCI. Computerised cognitive training (CCT) offers several advantages over traditional paper-and-pencil cognitive training and has the potential to be more individualised by matching task difficulty with individual performance. Recent systematic reviews have reported promising effects of CCT on improving the cognitive capacities of people with MCI. However, the quality of existing studies has been limited, and it is still unclear whether CCT can influence the progression to dementia. We developed an ‘individualised’ CCT (MAKSCog) specialised for people with MCI that automatically matches task difficulty with individual performance and an active control training (‘basic’ CCT). The aims of the present study are (a) to evaluate MAKSCog and (b) to investigate whether it can be applied to maintain the cognitive abilities of people with MCI. Methods The present study investigates the effects of CCT on cognition in a randomised controlled intervention study in Germany. Participants are community-dwelling people with a psychometric diagnosis of MCI based on the Montreal Cognitive Assessment (MoCA) and Mini-Mental Status Test (MMSE). Screening and baseline testing are conducted via a videoconferencing assessment and telephone. Participants are randomly allocated. The treatment phase is 6 months with an open phase in which participants can freely decide to continue to use the CCTs. Additionally, both CCTs contain a monthly computerised cognitive assessment that measures different cognitive abilities: information processing speed, memory span, short term memory, and logical reasoning. Discussion This is the first study to investigate the effect of MAKSCog, an individualised CCT, specifically developed for people with different subtypes of MCI. A methodological strength is the double-blind, randomised, controlled design and the use of basic CCT as an active control group. The study is conducted entirely virtually with valid telehealth assessments for cognitive function. Methodological limitations might include a restriction to participants who feel comfortable with the use of technology and who own a computer, laptop, or tablet. Trial registration ISRCTN ISRCTN14437015. Prospectively registered on 27 February 2020.
Collapse
Affiliation(s)
- Stephanie Book
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Michael Jank
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Anna Pendergrass
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Elmar Graessel
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| |
Collapse
|
27
|
Salzman T, Sarquis-Adamson Y, Son S, Montero-Odasso M, Fraser S. Associations of Multidomain Interventions With Improvements in Cognition in Mild Cognitive Impairment: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e226744. [PMID: 35503222 PMCID: PMC9066287 DOI: 10.1001/jamanetworkopen.2022.6744] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IMPORTANCE Older adults with mild cognitive impairment (MCI) have the highest risk of progressing to dementia. Evidence suggests that nonpharmacological, single-domain interventions can prevent or delay progressive declines, but it is unclear whether greater cognitive benefits arise from multidomain interventions. OBJECTIVE To determine whether multidomain interventions, composed of 2 or more interventions, are associated with greater improvements in cognition among older adults with MCI than a single intervention on its own. DATA SOURCES MEDLINE, Embase, PsycInfo, AgeLine, CINAHL, and Cochrane Central Register of Controlled Trials were systematically searched from database inception to December 20, 2021. STUDY SELECTION Included studies contained (1) an MCI diagnosis; (2) nonpharmacological, multidomain interventions that were compared with a single active control; (3) older adults aged 65 years and older; and (4) randomized clinical trials. DATA EXTRACTION AND SYNTHESIS Data were screened and extracted by 3 independent reviewers. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, random-effects meta-analyses were used to calculate effect sizes from the standardized mean difference (SMD) and 95% CIs. MAIN OUTCOMES AND MEASURES Postintervention cognitive test scores in 7 cognitive domains were compared between single-domain and multidomain groups. Exposure to the intervention was analyzed. RESULTS A total of 28 studies published between 2011 and 2021, including 2711 older adults with MCI, reported greater effect sizes in the multidomain group for global cognition (SMD, 0.41; 95% CI, 0.23-0.59; P < .001), executive function (SMD, 0.20; 95% CI, 0.04-0.36; P = .01), memory (SMD, 0.29; 95% CI, 0.14-0.45; P < .001), and verbal fluency (SMD, 0.30; 95% CI, 0.12-0.49; P = .001). The Mini-Mental State Examination (SMD, 0.40; 95% CI, 0.17-0.64; P < .001), category verbal fluency test (SMD, 0.34; 95% CI, 0.13-0.56; P = .002), Trail Making Test-B (SMD, 0.46; 95% CI, 0.13-0.80; P = .007), and Wechsler Memory Scale-Logical Memory I (SMD, 0.47; 95% CI, 0.15-0.80; P < .001) and II (SMD, 0.26; 95% CI, 0.07-0.45; P < .001) favored the multidomain group. Exposure to the intervention varied between studies: the mean (SD) duration was 71.3 (36.0) minutes for 19.8 (14.6) weeks with sessions taking place 2.5 (1.1) times per week, and all interventions lasted less than 1 year. CONCLUSIONS AND RELEVANCE In this study, short-term multidomain interventions (<1 year) were associated with improvements in global cognition, executive function, memory, and verbal fluency compared with single interventions in older adults with MCI.
Collapse
Affiliation(s)
- Talia Salzman
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Yanina Sarquis-Adamson
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Surim Son
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Medicine and Division of Geriatric Medicine, The University of Western Ontario, London, Ontario, Canada
| | - Sarah Fraser
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| |
Collapse
|
28
|
Duff K, Ying J, Suhrie KR, Dalley BCA, Atkinson TJ, Porter SM, Dixon AM, Hammers DB, Wolinsky FD. Computerized Cognitive Training in Amnestic Mild Cognitive Impairment: A Randomized Clinical Trial. J Geriatr Psychiatry Neurol 2022; 35:400-409. [PMID: 33783254 DOI: 10.1177/08919887211006472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Computerized cognitive training has been successful in healthy older adults, but its efficacy has been mixed in patients with amnestic Mild Cognitive Impairment (MCI). METHODS In a randomized, placebo-controlled, double-blind, parallel clinical trial, we examined the short- and long-term efficacy of a brain-plasticity computerized cognitive training in 113 participants with amnestic MCI. RESULTS Immediately after 40-hours of training, participants in the active control group who played computer games performed better than those in the experimental group on the primary cognitive outcome (p = 0.02), which was an auditory memory/attention composite score. There were no group differences on 2 secondary outcomes (global cognitive composite and rating of daily functioning). After 1 year, there was no difference between the 2 groups on primary or secondary outcomes. No adverse events were noted. CONCLUSIONS Although the experimental cognitive training program did not improve outcomes in those with MCI, the short-term effects of the control group should not be dismissed, which may alter treatment recommendations for these patients.
Collapse
Affiliation(s)
- Kevin Duff
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, 14434University of Utah, UT, USA
| | - Jian Ying
- Department of Internal Medicine, 14434University of Utah, UT, USA
| | - Kayla R Suhrie
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, 14434University of Utah, UT, USA
| | - Bonnie C A Dalley
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, 14434University of Utah, UT, USA
| | - Taylor J Atkinson
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, 14434University of Utah, UT, USA.,School of Aging Studies, 7831University of South Florida, FL, USA
| | - Sariah M Porter
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, 14434University of Utah, UT, USA
| | - Ava M Dixon
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, 14434University of Utah, UT, USA
| | - Dustin B Hammers
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, 14434University of Utah, UT, USA
| | | |
Collapse
|
29
|
Pike KE, Wright BJ, Kinsella GJ. Observed Strategies on Naturalistic Associative Memory Tasks in Healthy Older Adults and Amnestic Mild Cognitive Impairment. Exp Aging Res 2022; 49:226-243. [PMID: 35451919 DOI: 10.1080/0361073x.2022.2068327] [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: 11/04/2022]
Abstract
BACKGROUND Understanding the strategies people with amnestic mild cognitive impairment (aMCI) spontaneously use can inform targeted memory training. METHOD Strategy use was observed for 99 people with aMCI and 100 healthy older adults (HOA) on two memory tasks. RESULTS No differences were found between aMCI and HOA in the amount or types of strategies used, but strategy use varied with task. Association was more effective for one task, whereas on the other task, use of written notes or multiple strategies were detrimental to performance and related to poorer performance than active (spaced) retrieval, for aMCI. CONCLUSION Our findings suggest the importance of identifying ineffective habits, in addition to instruction in more beneficial approaches.
Collapse
Affiliation(s)
- Kerryn E Pike
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.,John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, VIC, Australia
| | - Bradley J Wright
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Glynda J Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| |
Collapse
|
30
|
Oba K, Tamura Y, Ishikawa J, Suzuki H, Fujiwara Y, Tachibana A, Kodera R, Toyoshima K, Chiba Y, Araki A. Dynapenic abdominal obesity is associated with mild cognitive impairment in patients with cardiometabolic disease: a cross-sectional study. BMC Geriatr 2022; 22:255. [PMID: 35346081 PMCID: PMC8962154 DOI: 10.1186/s12877-022-02948-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/10/2022] [Indexed: 11/28/2022] Open
Abstract
Background Dementia is an important health issue for older people and requires early intervention in the mild cognitive impairment (MCI) stage to manage risk factors. Both dynapenia (DP) and abdominal obesity (AO) are associated with inflammation and oxidative stress, which may be involved in the pathogenesis of cognitive impairment. Therefore, in this cross-sectional study, we aimed to evaluate the association between MCI and dynapenic abdominal obesity (DAO), a combination of DP and AO. Methods A total of 417 older outpatients with cardiometabolic diseases without severe cognitive impairment were studied to compare cognitive function in four groups: control, DP, AO, and DAO groups. DAO was defined as the combination of DP (handgrip strength of < 28 kg and < 18 kg in men and women, respectively) and AO (waist circumference of ≥ 85 cm and ≥ 90 cm in men and women, respectively). MCI was defined as a score of ≤ 25 in the Japanese version of the Montreal Cognitive Assessment. Multiple regression analyses were performed to examine if MCI was independently associated with DAO, low handgrip strength, or high waist circumference. Results The DAO group obtained the lowest cognitive test scores and had the highest prevalence of MCI. Furthermore, after adjusting for covariates, the logistic regression analysis showed that patients in the DAO group were at an increased risk of MCI (odds ratio [OR] = 3.98, 95% confidence interval [CI]: 1.15–13.77). Further logistic regression analyses revealed that both low handgrip strength (OR = 2.19, 95% CI: 1.11–4.29) and high waist circumference (OR = 2.03, 95% CI: 1.03–3.99) were associated with MCI. Conclusions DAO, which can be easily diagnosed by a combination of handgrip strength and waist circumference, was associated with MCI in patents with cardiometabolic metabolic disease. This study suggests that screening for MCI in DAO patients could be important for early intervention of dementia prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02948-1.
Collapse
|
31
|
Klaming L, Robbemond L, Lemmens P, Hart de Ruijter E. Digital Compensatory Cognitive Training for Older Adults with Memory Complaints. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2044989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Laura Klaming
- Philips Research Brain, Behavior & Cognition High Tech Campus 34, Eindhoven, Netherlands
| | - Lisanne Robbemond
- University of Groningen, University Center of Psychiatry, Groningen, The Netherlands
| | - Paul Lemmens
- Philips Research Brain, Behavior & Cognition High Tech Campus 34, Eindhoven, Netherlands
| | | |
Collapse
|
32
|
Ogonowski N, Salcidua S, Leon T, Chamorro-Veloso N, Valls C, Avalos C, Bisquertt A, Rentería ME, Orellana P, Duran-Aniotz C. Systematic Review: microRNAs as Potential Biomarkers in Mild Cognitive Impairment Diagnosis. Front Aging Neurosci 2022; 13:807764. [PMID: 35095478 PMCID: PMC8790149 DOI: 10.3389/fnagi.2021.807764] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/15/2021] [Indexed: 12/14/2022] Open
Abstract
The rate of progression from Mild Cognitive Impairment (MCI) to Alzheimer's disease (AD) is estimated at >10% per year, reaching up to 80-90% after 6 years. MCI is considered an indicator of early-stage AD. In this context, the diagnostic screening of MCI is crucial for detecting individuals at high risk of AD before they progress and manifest further severe symptoms. Typically, MCI has been determined using neuropsychological assessment tools such as the Montreal Cognitive Assessment (MoCA) or Mini-Mental Status Examination (MMSE). Unfortunately, other diagnostic methods are not available or are unable to identify MCI in its early stages. Therefore, identifying new biomarkers for MCI diagnosis and prognosis is a significant challenge. In this framework, miRNAs in serum, plasma, and other body fluids have emerged as a promising source of biomarkers for MCI and AD-related cognitive impairments. Interestingly, miRNAs can regulate several signaling pathways via multiple and diverse targets in response to pathophysiological stimuli. This systematic review aims to describe the current state of the art regarding AD-related target genes modulated by differentially expressed miRNAs in peripheral fluids samples in MCI subjects to identify potential miRNA biomarkers in the early stages of AD. We found 30 articles that described five miRNA expression profiles from peripheral fluid in MCI subjects, showing possible candidates for miRNA biomarkers that may be followed up as fluid biomarkers or therapeutic targets of early-stage AD. However, additional research is needed to validate these miRNAs and characterize the precise neuropathological mechanisms.
Collapse
Affiliation(s)
- Natalia Ogonowski
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), National Scientific and Technical Research Council (CONICET), Universidad de San Andrés, Buenos Aires, Argentina
| | - Stefanny Salcidua
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Faculty of Engineering and Sciences, Universidad Adolfo Ibanez, Santiago, Chile
| | - Tomas Leon
- Global Brain Health Institute, Trinity College, Dublin, Ireland
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | | | - Constanza Avalos
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
| | | | - Miguel E. Rentería
- Department of Genetics and Computational Biology, Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Paulina Orellana
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia Duran-Aniotz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| |
Collapse
|
33
|
Levy SA, Smith G, De Wit L, DeFeis B, Ying G, Amofa P, Locke D, Shandera-Ochsner A, McAlister C, Phatak V, Chandler M. Behavioral Interventions in Mild Cognitive Impairment (MCI): Lessons from a Multicomponent Program. Neurotherapeutics 2022; 19:117-131. [PMID: 35415779 PMCID: PMC9130435 DOI: 10.1007/s13311-022-01225-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 01/03/2023] Open
Abstract
Comparative effectiveness of behavioral interventions to mitigate the impacts of degeneration-based cognitive decline is not well understood. To better address this gap, we summarize the studies from the Healthy Action to Benefit Independence & Thinking (HABIT®) program, developed for persons with mild cognitive impairment (pwMCI) and their partners. HABIT® includes memory compensation training, computerized cognitive training (CCT), yoga, patient and partner support groups, and wellness education. Studies cited include (i) a survey of clinical program completers to establish outcome priorities; (ii) a five-arm, multi-site cluster randomized, comparative effectiveness trial; (iii) and a three-arm ancillary study. PwMCI quality of life (QoL) was considered a high-priority outcome. Across datasets, findings suggest that quality of life was most affected in groups where wellness education was included and CCT withheld. Wellness education also had greater impact on mood than CCT. Yoga had a greater impact on memory-dependent functional status than support groups. Yoga was associated with better functional status and improved caregiver burden relative to wellness education. CCT had the greatest impact on cognition compared to yoga. Taken together, comparisons of groups of program components suggest that knowledge-based interventions like wellness education benefit patient well-being (e.g., QoL and mood). Skill-based interventions like yoga and memory compensation training aid the maintenance of functional status. Notably, better adherence produced better outcomes. Future personalized intervention approaches for pwMCI may include different combinations of behavioral strategies selected to optimize outcomes prioritized by patient values and preferences.
Collapse
Affiliation(s)
- Shellie-Anne Levy
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA.
| | - Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Brittany DeFeis
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Gelan Ying
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Priscilla Amofa
- Department of Clinical and Health Psychology, University of Florida, Gainesville, PO Box 100165, Florida, FL, 32653, USA
| | - Dona Locke
- Division of Neuropsychology, Mayo Clinic, Scottsdale, AZ, USA
| | - Anne Shandera-Ochsner
- Department of Psychiatry and Psychology, Mayo Clinic Health System, La Crosse, WI, USA
| | - Courtney McAlister
- Department of Psychiatry and Psychology, Mayo Clinic Health System, La Crosse, WI, USA
| | - Vaishali Phatak
- Department of Neurological Sciences, University of Nebraska Medical Center Omaha, Nebraska, USA
| | - Melanie Chandler
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
34
|
Xue B, Xiao A, Luo X, Li R. The effect of a game training intervention on cognitive functioning and depression symptoms in the elderly with mild cognitive impairment: A randomized controlled trial. Int J Methods Psychiatr Res 2021; 30:e1887. [PMID: 34291527 PMCID: PMC8633942 DOI: 10.1002/mpr.1887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/10/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to explore whether game training could improve cognitive functioning and depression symptoms in the elderly affected by mild cognitive impairment (MCI). METHODS A non-blinded randomized controlled trial was conducted. Participants were 72 patients with MCI and depression from a nursing home in Wuhan. Participants were randomized to either the intervention group or the control group (n = 36 each). The intervention group received regular nursing care plus game training for 50 min, three times per week for 8 weeks, whereas the control group received only regular nursing care during the same research period. Cognitive functioning and depression symptoms were tested in both groups at baseline and at the end of the 8-week intervention. We used the Montreal Cognitive Assessment and the 15-item Geriatric Depression Scale to assess cognitive functioning and depression symptoms, respectively. RESULTS The 8-week game training intervention significantly improved the cognitive and depression scores when compared with the control group and baseline scores (p < 0.05). No significant difference was observed in the control group (p > 0.05). CONCLUSIONS Our results suggest that the implementation of game training can improve the cognitive functioning and depression symptoms of the elderly with MCI, indicated that can be widely used.
Collapse
Affiliation(s)
- Bing Xue
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Ao Xiao
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xianwu Luo
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China.,Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
| | - Rui Li
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
| |
Collapse
|
35
|
Lee HM, Shin SW, Moon HS, Chung ST. Research trends in computerized cognitive training contents with text network. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-189985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Computerized Cognitive Training (CCT) contents used to improve patients’ cognitive ability with Mild Cognitive Impairment (MCI) can provide customized training through individual data collection and analysis. However, studies on transfer effect of improving other untrained cognitive domains while performing the contents are insufficient. The present paper intended to collect literature published by PubMed, EMBASE, Cochrane Library, and Web of Science until December 2019 and analyze the trends of CCT and the transfer effect in each training area. Studies on CCT (82/891) have been increasing each year, and universities (60/82) in the United States (17/82) have published the most. In the literature that reported clinical effect (18/82), the cognitive domain mostly studied was memory (14/18), and the N-Back (3/14) method accounted for most of the training contents. Moreover, the contents that showed the highest degree, closeness, and betweenness centrality (BC) indices were the memory area, and video accounted for the highest among the intervention methods. In particular, the closeness centrality (CC) index of the memory and attention contents showed similar results. It can be interpreted that the possibility of the transfer effect occurring from memory and attention areas is the highest since the semantic distance (i.e. the similarity of the training process) between the attention contents and memory contents was the closest. The effectiveness of the actual transfer effect between the memory and attention should be verified.
Collapse
Affiliation(s)
- Hyeok-Min Lee
- Department of IT Semiconductor Convergence, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
| | - Sung-Wook Shin
- Department of Computer Engineering, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
| | - Ho-Sang Moon
- Department of IT Semiconductor Convergence, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
| | - Sung-Taek Chung
- Department of Computer Engineering, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
| |
Collapse
|
36
|
Chow G, Gan JKE, Chan JKY, Wu XV, Klainin-Yobas P. Effectiveness of psychosocial interventions among older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021; 25:1986-1997. [PMID: 33200623 DOI: 10.1080/13607863.2020.1839861] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This review aimed to examine available evidence concerning the effectiveness of psychosocial interventions in improving memory, executive function, depression and activities of daily living (ADL) in older adults with MCI. METHODS Eight electronic databases were used to conduct a comprehensive literature search for published and unpublished studies. A primary outcome was cognitive function, including memory and executive function. Secondary outcomes were depression and ADL. Two researchers independently appraised quality of included studies and extracted data. Meta-analysis, heterogeneity test, subgroup analysis and sensitivity analyses were performed. RESULTS Ten studies (out of 1,265 records) were included in this review. Psychosocial interventions contributed to a significant improvement in memory, not executive function, depression and ADL. Subgroup analyses suggested that interventions with a longer duration, more therapeutic sessions, and individual format had larger effect sizes. Strategies found to enhance memory entailed behavior modification and activation, memory training, visual imagery, storytelling, memory aids, journaling, and exercise. CONCLUSION Healthcare providers may offer psychosocial interventions to client with MCI in clinical settings. Higher quality trials should be conducted to increase solid evidence in this domain.
Collapse
Affiliation(s)
- Gigi Chow
- Khoo Teck Puat Hospital, Singapore, Singapore
| | | | | | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
| |
Collapse
|
37
|
Chang LH, Chen PY, Wang J, Shih BH, Tseng YH, Mao HF. High-Ecological Cognitive Intervention to Improve Cognitive Skills and Cognitive-Functional Performance for Older Adults With Mild Cognitive Impairment. Am J Occup Ther 2021; 75:14121. [PMID: 34780638 DOI: 10.5014/ajot.2021.041996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Evidence of the effectiveness of cognitive activity and preparatory tasks in improving the cognitive skills and functional performance of people with cognitive decline is limited. OBJECTIVE To examine the efficacy of a high-ecological cognitive intervention. DESIGN Quasi-experimental, pretest-posttest design with nonequivalent control. SETTING Community. PARTICIPANTS Older adults with mild cognitive impairment from two senior centers. INTERVENTION Twelve 90-min weekly group sessions of a high-ecological cognitive intervention using simulated everyday cognitive tasks (experimental group) and of nutrition education (active control group). Outcomes and Measures: Cognitive skills were measured with the Color Trails Test (CTT), the Contextual Memory Test (CMT; Immediate Recall [CMT-Im] and Delayed Recall [CMT-De] tasks), and the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span subtest (Digits Forward and Digits Backward). Cognitive-functional performance was measured with the Rivermead Behavioural Memory Test-Third Edition (RBMT-3; Immediate Recall [RBMT-3-Im] and Delayed Recall [RBMT-3-De] tasks) and the Cognitive Failures Questionnaire (CFQ). RESULTS Thirty-seven participants (M age = 70.84 yr; 70.3% women) met the inclusion criteria for analysis (20 participants in the intervention group, 17 participants in the control group). Multivariate linear regression showed that the intervention group improved significantly more than the control group on the CTT, CMT-Im, and RBMT-3-Im but not on the CMT-De, RBMT-3-De, and CFQ. CONCLUSIONS AND RELEVANCE Twelve 90-min weekly group sessions of a high-ecological cognitive intervention improved attention, executive function, immediate memory, and objective cognitive-functional performance with immediate-memory task demands. What This Article Adds: Carefully designed and structured simulated everyday cognitive tasks can be used as a cognitive training agent to improve both cognitive skills and objective cognitive-functional performance. The effectiveness of group-based cognitive interventions depends on the skills of occupational therapy practitioners in activity analysis and grading.
Collapse
Affiliation(s)
- Ling-Hui Chang
- Ling-Hui Chang, PhD, is Associate Professor, Department of Occupational Therapy and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Yen Chen
- Po-Yen Chen, MS, is Occupational Therapist, Department of Occupational Therapy, Jianan Psychiatric Center, Tainan, Taiwan
| | - Jye Wang
- Jye Wang, PhD, is Associate Professor, Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan
| | - Bin-Huei Shih
- Bin-Huei Shih, MS, is Doctoral Student, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hsuan Tseng
- Yu-Hsuan Tseng, BS, is Graduate Student, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Fen Mao
- Hui-Fen Mao, MS, is Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;
| |
Collapse
|
38
|
Comparative Effects of Physical Exercise and Other Behavioral Interventions on Functional Status Outcomes in Mild Cognitive Impairment. J Int Neuropsychol Soc 2021; 27:805-812. [PMID: 34308814 PMCID: PMC8458219 DOI: 10.1017/s1355617721000485] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Lifestyle modifications for those with mild cognitive impairment (MCI) may promote functional stability, lesson disease severity, and improve well-being outcomes such as quality of life. The current analysis of our larger comparative effectiveness study evaluated which specific combinations of lifestyle modifications offered as part of the Mayo Clinic Healthy Action to Benefit Independence in Thinking (HABIT) program contributed to the least functional decline in people with MCI (pwMCI) over 18 months. METHODS We undertook to compare evidence-based interventions with one another rather than to a no-treatment control group. The interventions were five behavioral treatments: computerized cognitive training (CCT), yoga, Memory Support System (MSS) training, peer support group (SG), and wellness education (WE), each delivered to both pwMCI and care partners, in a group-based program. To compare interventions, we randomly withheld one of the five HABIT® interventions in each of the group sessions. We conducted 24 group sessions with between 8 and 20 pwMCI-partner dyads in a session. RESULTS Withholding yoga led to the greatest declines in functional ability as measured by the Functional Activities Questionnaire and Clinical Dementia Rating. In addition, memory compensation (calendar) training and cognitive exercise appeared to have associations (moderate effect sizes) with better functional outcomes. Withholding SG or WE appeared to have little effect on functioning at 18 months. CONCLUSIONS Overall, these results add to the growing literature that physical exercise can play a significant and lasting role in modifying outcomes in a host of medical conditions, including neurodegenerative diseases.
Collapse
|
39
|
Zhao X, Liang W, Maes JHR. Associations Between Self- and Informant-Reported Abilities of Instrumental Activities of Daily Living and Cognitive Functions in Older Adults With Mild Cognitive Impairment. Arch Clin Neuropsychol 2021; 36:723-733. [PMID: 33200196 PMCID: PMC8296846 DOI: 10.1093/arclin/acaa110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/15/2020] [Accepted: 10/20/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Older adults (OAs) with mild cognitive impairment (MCI) show disabilities in
instrumental activities of daily living (IADLs), which have been linked to
compromised cognitive functioning. However, it is unclear which cognitive
functions are primarily involved. The present study sought to identify the
cognitive function(s) most strongly associated with the IADL limitations in
MCI. Method OAs with MCI (N = 120) completed cognitive tasks measuring
general cognitive processing speed, working memory (WM) maintenance and
updating, inhibition, and shifting ability. IADL abilities were assessed
through both self- and informant reports. Results Self-reported IADL abilities were positively associated with both cognitive
processing speed and WM updating capacity. Informant-reported IADL abilities
were also positively associated with processing speed and WM updating, in
addition to cognitive shifting ability. Conclusion Both general processing speed and WM updating capacity were consistently
predictive of IADL abilities. These results might inform the design of
training programs aimed at maintaining or improving functional independence
in individuals with MCI to focus more on these cognitive functions. However,
the strength of the association between specific cognitive functions and
IADL abilities in OAs with MCI depends on the source of the information
about the IADL abilities, which highlights the need for gathering data from
both the examinee and informants.
Collapse
Affiliation(s)
- Xin Zhao
- Behavior Rehabilitation Training Research Institution, School of Psychology, Northwest Normal University, 967 East Anning Road, Lanzhou, 730070, China
| | - Wenjia Liang
- Behavior Rehabilitation Training Research Institution, School of Psychology, Northwest Normal University, 967 East Anning Road, Lanzhou, 730070, China
| | - Joseph H R Maes
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, PO. Box 9104, Nijmegen, 6500 HE, The Netherlands
| |
Collapse
|
40
|
Lisko I, Kulmala J, Annetorp M, Ngandu T, Mangialasche F, Kivipelto M. How can dementia and disability be prevented in older adults: where are we today and where are we going? J Intern Med 2021; 289:807-830. [PMID: 33314384 PMCID: PMC8248434 DOI: 10.1111/joim.13227] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age-related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle-based intervention can prevent cognitive and functional decline amongst at-risk older adults from the general population. Within the World-Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self-management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.
Collapse
Affiliation(s)
- I. Lisko
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Faculty of Sport and Health Sciences and Gerontology Research CenterUniversity of JyväskyläJyväskyläFinland
| | - J. Kulmala
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
- School of Health Care and Social WorkSeinäjoki University of Applied SciencesSeinäjokiFinland
| | - M. Annetorp
- Karolinska University Hospital, Theme AgingStockholmSweden
| | - T. Ngandu
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
| | - F. Mangialasche
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Aging Research CenterDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - M. Kivipelto
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Karolinska University Hospital, Theme AgingStockholmSweden
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandHelsinkiFinland
- Ageing and Epidemiology (AGE) Research UnitSchool of Public HealthImperial College LondonLondonUK
| |
Collapse
|
41
|
McMurray J, Levy A, Holyoke P. Psychometric Evaluation and Workflow Integration Study of a Tablet-Based Tool to Detect Mild Cognitive Impairment in Older Adults: Protocol for a Mixed Methods Study. JMIR Res Protoc 2021; 10:e25520. [PMID: 34018966 PMCID: PMC8178737 DOI: 10.2196/25520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/16/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND With the rapid aging of the global population, experts anticipate a surge in the prevalence of mild cognitive impairment (MCI) and dementia worldwide. It is argued that developing more sensitive, easy to administer, and valid MCI screening tools for use in primary care settings may initiate timely clinical and personal care planning and treatment, enabling early access to programs and services. Including functional competence measures in screening tests makes them more ecologically valid and may help to identify cognitive deficits at an earlier stage. OBJECTIVE We aim to conduct a preliminary evaluative study comparing the sensitivity, specificity, and reliability of the BrainFx Screen (referred to as SCREEN hereafter), a novel digital tool designed to assess functional competence and detect early signs of cognitive impairment, with the Quick Mild Cognitive Impairment, a validated and highly sensitive tool that detects MCI in the older adult population. We will also investigate the perceived usefulness and integration of the SCREEN into primary care practice to identify demonstrable impacts on clinical workflow and health care providers' (HCP) perceptions of its success as a screening tool. Patients' perceptions of completing the SCREEN and its impact on their quality of life will also be explored. METHODS This study has a concurrent, mixed methods, prospective, and quasi-experimental design. Participants will be recruited from 5 primary care family health teams (FHTs; defined by multidisciplinary practice and capitated funding) across southwestern Ontario, Canada. Participants will include HCPs, patients, care partners, and FHT administrative executives. Patients 55 years and older with no history of diagnoses for MCI, dementia, or Alzheimer disease rostered in one of the FHTs participating in the study will be eligible to participate. Their care partners will help triangulate the qualitative data collected from patients. Participating FHTs will identify an occupational therapist from their site to participate in the study; this HCP will both administer the research protocol and participate in semistructured in-depth interviews and questionnaires. Principal component analysis will be conducted on the SCREEN data to understand the test components better. Tests comparing sensitivity, specificity, and test-retest reliability will assess the validity of SCREEN as a screening tool for MCI. RESULTS This paper describes the study protocol and its activities to date. Data collection was halted early because of COVID-19 restrictions on research activity, and data analysis is currently in progress. CONCLUSIONS At the end of the project, we anticipate having an initial comparative evaluation of the SCREEN as a tool for early detection of MCI in primary care older adult patient populations. Resource constraints on this research study limit our ability to conduct a randomized controlled trial; however, the results will assist developers of the SCREEN in determining whether rigorous controlled testing is warranted. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25520.
Collapse
|
42
|
Rotenberg S, Leung C, Quach H, Anderson ND, Dawson DR. Occupational performance issues in older adults with subjective cognitive decline. Disabil Rehabil 2021; 44:4681-4688. [PMID: 33989108 DOI: 10.1080/09638288.2021.1916626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To describe and categorize difficulties in daily activities of older adults with subjective cognitive decline (SCD) compared to individuals with mild cognitive impairment (MCI). METHODS Deductive quantitative content analysis was used to classify reported issues in the performance of meaningful daily activities, in older adults with SCD (n = 67; age= 70 ± 6.3) or MCI (n = 42; age= 72 ± 6.6). The occupational performance issues were identified using the Canadian Occupational Performance Measure, a semi-structured interview, and categorised using the International Classification of Functioning, Disability and Health (ICF). RESULTS Both groups identified issues in all nine ICF "Activities and Participation" domains, with no significant group effects on seven of them. The most frequently affected "Activities and Participation" domains in both groups were "Self-care" (e.g. exercise and diet); "Community, social and civic life" (e.g. social-leisure activities); and "General tasks and demands" (e.g. time management). Over 90% of the issues in both groups were described in the context of difficulties in "Mental functions" (e.g. memory and higher-level cognitive functions). CONCLUSIONS Older adults with SCD, although independent, identified a variety of daily activities that they are not performing satisfactorily, remarkably similar in nature to the occupational performance issues described by older adults with MCI.Implications for RehabilitationOlder adults with SCD identified difficulties in performing social and leisure activities, maintaining healthy lifestyle behaviours, and managing multiple daily tasks.The daily challenges described by older adults with SCD are similar in nature to those identified by those with MCI.Older adults with SCD and MCI describe their daily challenges are related not only to memory problems, but also to executive dysfunction.Interventions for older adults with SCD should aim to improve self-identified problems in everyday functioning.
Collapse
Affiliation(s)
- Shlomit Rotenberg
- Rotman Research Institute, Baycrest, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Calvin Leung
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Henry Quach
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest, Toronto, Canada.,Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Deirdre R Dawson
- Rotman Research Institute, Baycrest, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| |
Collapse
|
43
|
Reynolds GO, Willment K, Gale SA. Mindfulness and Cognitive Training Interventions in Mild Cognitive Impairment: Impact on Cognition and Mood. Am J Med 2021; 134:444-455. [PMID: 33385339 DOI: 10.1016/j.amjmed.2020.10.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.
Collapse
Affiliation(s)
| | - Kim Willment
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Seth A Gale
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
| |
Collapse
|
44
|
Boller B, Ouellet É, Belleville S. Using Virtual Reality to Assess and Promote Transfer of Memory Training in Older Adults With Memory Complaints: A Randomized Controlled Trial. Front Psychol 2021; 12:627242. [PMID: 33776848 PMCID: PMC7994284 DOI: 10.3389/fpsyg.2021.627242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 02/19/2021] [Indexed: 11/20/2022] Open
Abstract
In this proof-of-concept study, we assessed the potential for immersive virtual reality (VR) to measure transfer following strategic memory training, and whether efficacy and transfer are increased when training is complemented by practice in an immersive virtual environment. Forty older adults with subjective memory complaints were trained with the method of loci. They were randomized to either a condition where they practiced the strategy in VR (n = 20) or a control condition where they were familiarized with VR using a non-memory task (n = 20). Training efficacy was measured with word recall, and transfer of the training benefit was measured with a recall task completed in two VR tasks (primary outcomes) as well as a self-report memory questionnaire (secondary outcomes). Testing was administered before (PRE), midway (POST 3), and after (POST 6) training. Participants improved their scores on word recall. Regarding transfer measures, participants improved their performance in the two VR recall tasks but not on the self-report memory questionnaire. No significant group effect was observed. Improvement was found when comparing PRE to POST 3 with no further improvement at POST 6. Thus, strategic memory training improved the memory of seniors with memory complaints on word recall and a transfer task relying on a VR scenario that resembles real-life. However, no evidence supporting an increase in transfer effects was found when enriching training with VR memory exercises.
Collapse
Affiliation(s)
- Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Émilie Ouellet
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| |
Collapse
|
45
|
Pike KE, Moller CI, Bryant C, Farrow M, Dao DP, Ellis KA. Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) Program for Older Adults with Cognitive Concerns: Pilot Study Protocol. J Alzheimers Dis Rep 2021; 5:143-152. [PMID: 33782667 PMCID: PMC7990456 DOI: 10.3233/adr-200251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Memory interventions for older adults with cognitive concerns result in improved memory performance and maintenance of cognitive health. These programs are typically delivered face-to-face, which is resource intensive and creates access barriers, particularly for those with reduced mobility, limited transportation, and living in rural or remote areas. The COVID-19 pandemic has created an additional access barrier, given the increased risk this disease poses to older adults. Internet-based interventions seek to overcome these barriers. This paper describes the protocol of a pilot study that aims to evaluate the feasibility, acceptability, and efficacy of one such internet-based intervention: the Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) program. OPTIMiSE focuses on improving knowledge regarding memory and providing training in effective memory strategies for everyday life. The pilot study described in this protocol will be a single-arm pre-post study of 8 weeks duration, with a single maintenance session 3 months post-intervention. Participants will be Australian adults aged ≥60 years reporting cognitive changes compared with 10 years ago. Primary outcome measures will address feasibility, acceptability, and efficacy. Secondary outcome measures assessing sense of community and self-efficacy will be administered at the 8-week and 3-month timepoints. Data collection will conclude mid-2021, and results will be presented in a subsequent publication. Translation of memory interventions to internet-based delivery has the potential to remove many access barriers for older adults; however, the acceptability and feasibility of this modality needs investigation. OPTIMiSE is the initial step in what could be an important program enabling access to an evidence-based memory intervention for older adults worldwide. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12620000979954.
Collapse
Affiliation(s)
- Kerryn E Pike
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Carl I Moller
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Maree Farrow
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
| | - Duy P Dao
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Kathryn A Ellis
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.,Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
46
|
Shaikh KT, Tatham EL, Rich JB, Troyer AK. Examining the factor structure of the Multifactorial Memory Questionnaire. Memory 2021; 29:255-260. [PMID: 33480308 DOI: 10.1080/09658211.2021.1874995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Many adults report memory changes as they age. The Multifactorial Memory Questionnaire (MMQ) measures different aspects of self-reported memory, including satisfaction with one's memory, self-appraisal of memory ability, and compensatory strategy use. This questionnaire has been extensively used for clinical and research purposes, with studies reporting differences in the factor structure (three or four factors) underlying this measure. The current study evaluates previously reported factor configurations of the MMQ using best measurement practices. Confirmatory factor analyses were conducted on data from 560 cognitively - normal adults, ranging in age from 50 to 90 years old. Our results demonstrate support for both 3-factor model (with Satisfaction, Ability and Strategy scales) and 4-factor model structure (with Satisfaction, Ability, Internal Strategy and External Strategy scales) of this instrument. These results harmonise the existing literature which, in separate studies using exploratory analyses, supports the validity of one model or the other. The confirmation of multiple Strategy scales will provide clinicians and researchers with additional relevant information about how older adults compensate for their memory changes, enabling a broader understanding of the experience of age-related memory change. We contextualise these results within existing research identifying conceptual differences between internal and external strategy implementation.
Collapse
Affiliation(s)
- Komal T Shaikh
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Erica L Tatham
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Jill B Rich
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| |
Collapse
|
47
|
Efficacy of cognitive intervention programs in amnesic mild cognitive impairment: A systematic review. Arch Gerontol Geriatr 2021; 94:104332. [PMID: 33486120 DOI: 10.1016/j.archger.2020.104332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Amnesic mild cognitive impairment (aMCI) is considered a prodromal stage of Alzheimer's disease. Given the absence of an effective pharmacological treatment for aMCI, increasing numbers of studies are attempting to understand how cognitive interventions could benefit aMCI patients. The aim of this systematic review was to evaluate the current evidence regarding the efficacy on cognition of cognitive intervention programs in older adults with aMCI. METHODS We searched for randomized controlled trials and clinical trials published until March 2020 on PubMed, Web of Science, Cochrane Library, SCOPUS, and OTseeker. A total of 454 works were identified and 7 studies that met the inclusion criteria, were included in this review. PRISMA guidelines were followed and PEDro scale was included for the measurement of the quality of the selected studies. RESULTS Cognitive interventions showed positive effects on cognition. Cognitive training programs considerably enhanced the Mini Mental State Examination scores. However, no relevant differences in global cognition were found using other assessment tools as DRS-2 or ADAS-Cog Scale. Cognitive training and cognitive rehabilitation programs seemed to improve several cognitive domains as memory, language or executive function in aMCI patients in both post-training and at follow-up analysis. CONCLUSIONS Our findings support that cognitive interventions can be an effective option for people with aMCI. Cognitive interventions improved global cognitive function post-intervention, but also seemed to enhance some cognitive domains post-intervention and at follow-up. However, more studies are needed to analyze the potential benefits of cognitive intervention on aMCI.
Collapse
|
48
|
Bogolepova A, Vasenina E, Gomzyakova N, Gusev E, Dudchenko N, Emelin A, Zalutskaya N, Isaev R, Kotovskaya Y, Levin O, Litvinenko I, Lobzin V, Martynov M, Mkhitaryan E, Nikolay G, Palchikova E, Tkacheva O, Cherdak M, Chimagomedova A, Yakhno N. Clinical Guidelines for Cognitive Disorders in Elderly and Older Patients. Zh Nevrol Psikhiatr Im S S Korsakova 2021. [DOI: 10.17116/jnevro20211211036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
49
|
Pike KE, Chong MS, Hume CH, Keech BJ, Konjarski M, Landolt KA, Leslie BE, Russo A, Thai C, Vilsten JS, Kinsella GJ. Providing Online Memory Interventions for Older Adults: A Critical Review and Recommendations for Development. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12339] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Mei San Chong
- School of Psychology and Public Health, La Trobe University,
| | | | | | | | | | | | - Adrian Russo
- School of Psychology and Public Health, La Trobe University,
| | - Christine Thai
- School of Psychology and Public Health, La Trobe University,
| | | | - Glynda Jane Kinsella
- School of Psychology and Public Health, La Trobe University,
- Department of Psychology, Caulfield Hospital,
| |
Collapse
|
50
|
Simon SS, Hampstead BM, Nucci MP, Ferreira LK, Duran FLS, Fonseca LM, Martin MDGM, Ávila R, Porto FHG, Brucki SMD, Martins CB, Tascone LS, Jr. EA, Busatto GF, Bottino CMC. Mnemonic strategy training modulates functional connectivity at rest in mild cognitive impairment: Results from a randomized controlled trial. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12075. [PMID: 33204817 PMCID: PMC7647944 DOI: 10.1002/trc2.12075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Mnemonic strategy training (MST) has been shown to improve cognitive performance and increase brain activation in those with mild cognitive impairment (MCI). However, little is known regarding the effects of MST on functional connectivity (FC) at rest. The aim of the present study was to investigate the MST focused on face-name associations effect on resting-state FC in those with MCI. METHODS Twenty-six amnestic MCI participants were randomized in MST (N = 14) and Education Program (active control; N = 12). Interventions occurred twice a week over two consecutive weeks (ie, four sessions). Resting-state functional magnetic resonance imaging was collected at pre- and post-intervention. Regions of interest (ROIs) were selected based on areas that previously showed task-related activation changes after MST. Changes were examined through ROI-to-ROI analysis and significant results were corrected for multiple comparisons. RESULTS At post-intervention, only the MST group showed increased FC, whereas the control group showed decreased or no change in FC. After MST, there was an increased FC between the left middle temporal gyrus and right orbitofrontal cortex. In addition, a time-by-group interaction indicated that the MST group showed greater increased FC between the right inferior frontal gyrus and left brain regions, such as fusiform gyrus, temporal pole, and orbitofrontal cortex relative to controls. DISCUSSION MST enhanced FC in regions that are functionally relevant for the training; however, not in all ROIs investigated. Our findings suggest that MST-induced changes are reflected in task-specific conditions, as previously reported, but also in general innate connectivity. Our results both enhance knowledge about the mechanisms underlying MST effects and may provide neurophysiological evidence of training transfer.
Collapse
Affiliation(s)
- Sharon Sanz Simon
- Old Age Research Group (PROTER)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Benjamin M. Hampstead
- Department of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
- Mental Health ServiceVA Ann Arbor Healthcare SystemAnn ArborMichiganUSA
| | - Mariana P. Nucci
- Neuroimagem Funcional (NIF) ‐ Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM‐44)Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Luiz Kobuti Ferreira
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Fábio L. S. Duran
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Luciana M. Fonseca
- Old Age Research Group (PROTER)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Maria da Graça M. Martin
- Neuroimagem Funcional (NIF) ‐ Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM‐44)Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Renata Ávila
- Old Age Research Group (PROTER)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Fábio H. G. Porto
- Old Age Research Group (PROTER)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Sônia M. D. Brucki
- Department of NeurologyFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Camila B. Martins
- Department of Preventive MedicinePaulista School of MedicineFederal University of São PauloSão PauloBrazil
| | - Lyssandra S. Tascone
- Old Age Research Group (PROTER)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Edson Amaro Jr.
- Neuroimagem Funcional (NIF) ‐ Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM‐44)Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Geraldo F. Busatto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| | - Cássio M. C. Bottino
- Old Age Research Group (PROTER)Department and Institute of PsychiatryFaculty of MedicineUniversity of São PauloSão PauloBrazil
| |
Collapse
|