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Hardcastle C, Kraft JN, Hausman HK, O'Shea A, Albizu A, Evangelista ND, Boutzoukas EM, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, Porges E, DeKosky ST, Hishaw GA, Wu SS, Marsiske M, Cohen R, Alexander GE, Woods AJ. Learning ratio performance on a brief visual learning and memory test moderates cognitive training gains in Double Decision task in healthy older adults. GeroScience 2024; 46:3929-3943. [PMID: 38457007 PMCID: PMC11226577 DOI: 10.1007/s11357-024-01115-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024] Open
Abstract
Cognitive training using a visual speed-of-processing task, called the Useful Field of View (UFOV) task, reduced dementia risk and reduced decline in activities of daily living at a 10-year follow-up in older adults. However, there was variability in the achievement of cognitive gains after cognitive training across studies, suggesting moderating factors. Learning trials of visual and verbal learning tasks recruit similar cognitive abilities and have overlapping neural correlates with speed-of-processing/working memory tasks and therefore could serve as potential moderators of cognitive training gains. This study explored the association between the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) learning with a commercial UFOV task called Double Decision. Through a secondary analysis of a clinical trial, we assessed the moderation of HVLT-R and BVMT-R learning on Double Decision improvement after a 3-month speed-of-processing/attention and working memory cognitive training intervention in a sample of 75 cognitively healthy older adults. Multiple linear regressions showed that better baseline Double Decision performance was significantly associated with better BVMT-R learning (β = - .303). This association was not significant for HVLT-R learning (β = - .142). Moderation analysis showed that those with poorer BVMT-R learning improved the most on the Double Decision task after cognitive training. This suggests that healthy older adults who perform below expectations on cognitive tasks related to the training task may show the greatest training gains. Future cognitive training research studying visual speed-of-processing interventions should account for differing levels of visuospatial learning at baseline, as this could impact the magnitude of training outcomes and efficacy of the intervention.
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Affiliation(s)
- Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Emily J Van Etten
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Steven T DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, USA
- Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Samuel S Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
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Montejo Carrasco P, Montenegro-Peña M, Prada Crespo D, Rodríguez Rojo I, Barabash Bustelo A, Montejo Rubio B, Marcos Dolado A, Maestú Unturbe F, Delgado Losada ML. APOE genotype, hippocampal volume, and cognitive reserve predict improvement by cognitive training in older adults without dementia: a randomized controlled trial. Cogn Process 2024:10.1007/s10339-024-01202-3. [PMID: 38896211 DOI: 10.1007/s10339-024-01202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
Cognitive training (CT) programs aim to improve cognitive performance and impede its decline. Thus, defining the characteristics of individuals who can benefit from these interventions is essential. Our objectives were to assess if the cognitive reserve (CR), APOE genotype (e4 carriers/non-carriers) and/or hippocampal volume might predict the effectiveness of a CT program. Participants were older adults without dementia (n = 226), randomized into parallel experimental and control groups. The assessment consisted of a neuropsychological protocol and additional data regarding total intracranial, gray matter, left/right hippocampus volume; APOE genotype; and Cognitive Reserve (CR). The intervention involved multifactorial CT (30 sessions, 90 min each), with an evaluation pre- and post-training (at six months); the control group simply following the center's routine activities. The primary outcome measures were the change in cognitive performance and the predictors of change. The results show that APOE-e4 non-carriers (79.1%) with a larger left hippocampal volume achieved better gains in semantic verbal fluency (R2 = .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R2 = .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R2 = .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R2 = .087). In conclusion, besides the program itself, the effectiveness of CT depends on age, biological factors like genotype and brain volume, and CR. Thus, to achieve better results through a CT, it is essential to consider the different characteristics of the participants, including genetic factors.Trial registration: Trial retrospectively registered on January 29th, 2020-(ClinicalTrials.gov -NCT04245579).
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Affiliation(s)
- Pedro Montejo Carrasco
- Centre for the Prevention of Cognitive Impairment, Madrid Salud, Madrid City Council, Montesa 22 Building B, 28006, Madrid, Spain
| | - Mercedes Montenegro-Peña
- Centre for the Prevention of Cognitive Impairment, Madrid Salud, Madrid City Council, Montesa 22 Building B, 28006, Madrid, Spain.
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain.
| | - David Prada Crespo
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain
- Department of Psychology, Faculty of Biomedical and Health Sciences, European University, Madrid, Spain
| | - Inmaculada Rodríguez Rojo
- Center for Cognitive and Computational Neuroscience, Complutense University, Madrid, Spain
- Department of Nursing and Physiotherapy, Alcalá University, Madrid, Spain
| | - Ana Barabash Bustelo
- Endocrinology and Nutrition Department, San Carlos Clinic Hospital, Health Research Institute of the San Carlos Clinic Hospital (IdISSC), Madrid, Spain
- Department of Medicine II, Faculty of Medicine, Complutense University, Madrid, Spain
| | | | - Alberto Marcos Dolado
- Department of Neurology, San Carlos Clinic Hospital, Health Research Institute of the San Carlos Clinic Hospital (IdISSC), Madrid, Spain
| | - Fernando Maestú Unturbe
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University, Madrid, Spain
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Cipolletta S, Signorello D, Zuppiroli S, Hering A, Ballhausen N, Mioni G, Kliegel M, Gaspari M, Stablum F. A focus group study for the design of a web-based tool for improving problem-solving in older adults. Eur J Ageing 2024; 21:19. [PMID: 38869644 DOI: 10.1007/s10433-024-00814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 06/14/2024] Open
Abstract
The development of easily accessible and usable social and cognitive enhancement trainings is becoming a priority to reduce the impact of aging on quality of life. Since most activities of daily living (e.g., making a meal) require problem-solving skills, problem-solving interventions could be used to improve and/or maintain functional abilities in aging to prolong independence. To design an effective problem-solving training and increase older adults' adherence to the training, this study examined older adults' perceptions of their challenges in activities of daily living, their skills and difficulties in using information technology (IT), and their motivations and expectations for participating in a web-based problem-solving training activity. Four focus groups (two in Italy and two in the Netherlands) were conducted with older adults aged between 65 and 84 years, a total of 27 participants. The data were analyzed using the Atlas.ti 8 software for the thematic analysis. The analysis identified five thematic areas: interests and activities, difficulties and concerns, experiences and motivations for training, expertise and resources, suggestions for the design of the new training. The results were used to develop a first prototype of a Shared, Web-based, Intelligent Flexible Thinking Training (SWIFT), adapted to future user needs. The participation of older adults in this design phase was critical to understanding their needs, motivations, and expectations regarding the implementation and use of a cognitive enhancement training.
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Affiliation(s)
| | - Dario Signorello
- Department of General Psychology, University of Padova, Padua, Italy
| | - Sara Zuppiroli
- Department of Computer Science and Engineering, University of Bologna, Bologna, Italy
| | - Alexandra Hering
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Nicola Ballhausen
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Giovanna Mioni
- Department of General Psychology, University of Padova, Padua, Italy
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Mauro Gaspari
- Department of Computer Science and Engineering, University of Bologna, Bologna, Italy
| | - Franca Stablum
- Department of General Psychology, University of Padova, Padua, Italy
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Jansen MG, Oosterman JM, Folkerts AK, Chakraverty D, Kessels RPC, Kalbe E, Roheger M. Classification Of MeMory InTerventions: Rationale and developmental process of the COMMIT tool. Neuropsychol Rehabil 2024; 34:679-700. [PMID: 37523444 DOI: 10.1080/09602011.2023.2236346] [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: 10/25/2022] [Accepted: 06/29/2023] [Indexed: 08/02/2023]
Abstract
ABSTRACTOver the last decades, numerous memory interventions have been developed to mitigate memory decline in normal ageing. However, there is a large variability in the success of memory interventions, and it remains poorly understood which memory intervention programs are most effective and for whom. This is partially explained by the heterogeneity of memory intervention protocols across studies as well as often poor reporting of the study design. To facilitate a reporting framework that enables researchers to systemize the content and design of memory intervention paradigms, we developed the Classification Of MeMory InTerventions (COMMIT) tool using a 3-stage developmental process. Briefly, COMMIT was based on qualitative content analysis of already existing memory intervention studies published between April 1983 and July 2020, and iteratively validated by both internal and external expert panels. COMMIT provides an easily-applicable interactive tool that enables systematic description of memory intervention studies, together with instructions on how to use this classification tool. Our main goal is to provide a tool that enables the reporting and classification of memory interventions in a transparent, comprehensible, and complete manner, to ensure a better comparability between memory interventions, and, to ultimately contribute to the question which memory intervention shows the greatest benefits.
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Affiliation(s)
- Michelle G Jansen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Digo Chakraverty
- Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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5
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Lee ATC, Luo Y, Huo Z, Shi L, Chu WCW, Lam LCW. Effect of increasing cognitive activity participation on default mode network in older adults with subjective cognitive decline: a randomised controlled trial. EBioMedicine 2024; 102:105082. [PMID: 38531174 PMCID: PMC10982549 DOI: 10.1016/j.ebiom.2024.105082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/07/2024] [Accepted: 03/09/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Having more cognitive activities may prevent dementia, but its evidence of modulating the functional brain network is limited. This randomised controlled trial (RCT) investigated the effect of increased cognitive activity participation on the default mode network (DMN) in older adults who had already been having regular cognitive activity participation and experiencing subjective cognitive decline (SCD). METHODS Community-living Chinese individuals aged 55-75 years with regular practice of Chinese calligraphy and screened positive for SCD (but negative for mild cognitive impairment or dementia) were randomly allocated to either the intervention or control group. Over 6 months, the intervention group doubled their weekly calligraphy practice time, while the control group maintained their usual amount of practice. The primary outcome was functional connectivities (FCs) of DMN, with pre-specified regions of interest including medial prefrontal cortex (mPFC), inferior parietal lobe (IPL), hippocampal formation (HF), posterior cingulate cortex (PCC), and lateral temporal cortex (LTC). FC changes were compared using repeated measures multivariate analysis of variance (MANOVA). This study is registered at the Chinese Clinical Trial Registry, ChiCTR1900024433. FINDINGS Between 15 January 2020 and 31 December 2021, 112 individuals consented and completed the baseline assessment. The participants, who had a mean age of 66.3 (SD 4.3) years, with 83 (74%) being women, had been practising calligraphy for an average duration of 9.7 years before enrolment and, in the preceding six months, for an average of 3.1 hours per week. 96 (86%) completed the post-intervention fMRI scan. Significant between-group differences were observed in the FCs between mPFC and right LTC (group difference = 0.25 [95% CI = 0.06-0.44], p = 0.009), mPFC and right IPL (0.23 [0.06-0.39]; p = 0.007), left HF and right LTC (0.28 [0.002-0.57]; p = 0.04), and left HF and right IPL (0.34 [0.09-0.60]; p = 0.009). INTERPRETATION Our findings, which reveal positive neuromodulatory effects with increased calligraphy practice, highlight the importance of engaging more in cognitive activities in late life for better brain health. FUNDING Research Grants Council, Hong Kong (grant number 24114519).
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Affiliation(s)
- Allen Ting Chun Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yishan Luo
- BrainNow Medical Technology Limited, Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - Zhaohua Huo
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lin Shi
- BrainNow Medical Technology Limited, Hong Kong Science and Technology Park, Hong Kong SAR, China; Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Winnie Chiu Wing Chu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Figueroa-Vargas A, Góngora B, Alonso MF, Ortega A, Soto-Fernández P, Z-Rivera L, Ramírez S, González F, Muñoz Venturelli P, Billeke P. The effect of a cognitive training therapy based on stimulation of brain oscillations in patients with mild cognitive impairment in a Chilean sample: study protocol for a phase IIb, 2 × 3 mixed factorial, double-blind randomised controlled trial. Trials 2024; 25:144. [PMID: 38395980 PMCID: PMC10885461 DOI: 10.1186/s13063-024-07972-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The ageing population has increased the prevalence of disabling and high-cost diseases, such as dementia and mild cognitive impairment (MCI). The latter can be considered a prodromal phase of some dementias and a critical stage for interventions to postpone the impairment of functionality. Working memory (WM) is a pivotal cognitive function, representing the fundamental element of executive functions. This project proposes an intervention protocol to enhance WM in these users, combining cognitive training with transcranial electrical stimulation of alternating current (tACS). This technique has been suggested to enhance the neuronal plasticity needed for cognitive processes involving oscillatory patterns. WM stands to benefit significantly from this approach, given its well-defined electrophysiological oscillations. Therefore, tACS could potentially boost WM in patients with neurodegenerative diseases. METHODS This study is a phase IIb randomised, double-blind clinical trial with a 3-month follow-up period. The study participants will be 62 participants diagnosed with MCI, aged over 60, from Valparaíso, Chile. Participants will receive an intervention combining twelve cognitive training sessions with tACS. Participants will receive either tACS or placebo stimulation in eight out of twelve training sessions. Sessions will occur twice weekly over 6 weeks. The primary outcomes will be electroencephalographic measurements through the prefrontal theta oscillatory activity, while the secondary effects will be cognitive assessments of WM. The participants will be evaluated before, immediately after, and 3 months after the end of the intervention. DISCUSSION The outcomes of this trial will add empirical evidence about the benefits and feasibility of an intervention that combines cognitive training with non-invasive brain stimulation. The objective is to contribute tools for optimal cognitive treatment in patients with MCI. To enhance WM capacity, postpone the impairment of functionality, and obtain a better quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT05291208. Registered on 28 February 2022. ISRCTN87597719 retrospectively registered on 15 September 2023.
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Affiliation(s)
- Alejandra Figueroa-Vargas
- Laboratorio de Neurociencia Social y Neuromodulación del Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
- Laboratorio LaNCE, Centro Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Begoña Góngora
- Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Universidad de Valparaíso, Valparaíso, Chile.
| | - María Francisca Alonso
- Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Universidad de Valparaíso, Valparaíso, Chile
| | - Alonso Ortega
- Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Universidad de Valparaíso, Valparaíso, Chile
| | - Patricio Soto-Fernández
- Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Universidad de Valparaíso, Valparaíso, Chile
| | - Lucía Z-Rivera
- Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Universidad de Valparaíso, Valparaíso, Chile
| | - Sebastián Ramírez
- Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Universidad de Valparaíso, Valparaíso, Chile
| | - Francisca González
- Centro de Estudios Clínicos, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Paula Muñoz Venturelli
- Centro de Estudios Clínicos, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Pablo Billeke
- Laboratorio de Neurociencia Social y Neuromodulación del Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile.
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7
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Vance DE, Fazeli PL, Azuero A, Frank JS, Wadley VG, Raper JL, Pope CN, Ball KK. A 2-year longitudinal randomized controlled trial examining the transfer of speed of processing training to secondary cognitive domains in middle-aged and older adults with HIV-associated neurocognitive disorder: Results of the think fast study. Clin Neuropsychol 2024; 38:471-492. [PMID: 37191339 PMCID: PMC10651797 DOI: 10.1080/13854046.2023.2212867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/07/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE As people with HIV (PWH) age, they are at-risk of developing cognitive impairments compared to their seronegative counterparts. Although speed of processing (SOP) training may help improve this cognitive ability, less work has examined transfer to other cognitive domains. This study examined the effect of SOP training has on secondary cognitive domains in PWH aged 40+ years. METHOD In this 3-group 2-year longitudinal study, 216 PWH with HIV-associated neurocognitive disorder (HAND) or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73); or (3) 10 h of an active control training (n = 73). Participants completed a comprehensive cognitive battery at baseline, immediately after training, and at 1 and 2 years. This battery yielded global and domain specific T-scores as well as a cognitive impairment variable. Generalized linear mixed-effect models were fitted to estimate between-group mean differences at the follow-up time-points adjusted for baseline. RESULTS No clinically or statistically significant improvements in any of the cognitive outcomes were observed. A sensitivity analysis was conducted; conclusions replicated those of the main analysis, with two exceptions: Global Function T and Psychomotor Speed T showed relevant training improvements among the intervention groups over the control group at the immediate post time point. CONCLUSIONS Although SOP training has been shown to improve cognitive abilities that correspond to driving and mobility, such training has limited therapeutic utility in improving cognition in other domains in PWH with HAND.
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Affiliation(s)
- David E. Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L. Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer S. Frank
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia G. Wadley
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James L. Raper
- The 1917 (HIV/AIDS) Clinic, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Caitlin N. Pope
- Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
| | - Karlene K. Ball
- UAB Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Dieciuc M, Zhang S, Gray N, Lustria MLA, Carr DC, Charness N, Boot WR. Terms of Engagement: Understanding the Motivations, Preferences, and Attitudes of Older Adults Toward Mobile Cognitive Assessment and Training. THE GERONTOLOGIST 2024; 64:gnad048. [PMID: 37097773 PMCID: PMC10825850 DOI: 10.1093/geront/gnad048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The future of cognitive assessment is likely to involve mobile applications for smartphones and tablets; cognitive training is also often delivered in these formats. Unfortunately, low adherence to these programs can hinder efforts at the early detection of cognitive decline and interfere with examining cognitive training efficacy in clinical trials. We explored factors that increase adherence to these programs among older adults. RESEARCH DESIGN AND METHODS Focus groups were conducted with older adults (N = 21) and a younger adult comparison group (N = 21). Data were processed using reflexive thematic analysis with an inductive, bottom-up approach. RESULTS Three primary themes related to adherence were developed from the focus group data. Switches of engagement reflects factors that must be present; without them, engagement is unlikely. Dials of engagement reflects a cost-benefit analysis that users undergo, the outcome of which determines whether a person will be more or less likely to engage. Bracers of engagement reflects factors that nudge users toward engagement by minimizing barriers associated with the other themes. Older adults in general were more sensitive to opportunity costs, preferred more cooperative interactions, and were more likely to mention technology barriers. DISCUSSION AND IMPLICATIONS Our results are important for informing the design of mobile cognitive assessment and training apps for older adults. These themes provide guidance about ways apps could be modified to increase engagement and adherence, which in turn can more effectively facilitate the early detection of cognitive impairment and the evaluation of cognitive training efficacy.
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Affiliation(s)
- Michael Dieciuc
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Shenghao Zhang
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Nicholas Gray
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA
| | - Mia Liza A Lustria
- School of Information, Florida State University, Tallahassee, Florida, USA
| | - Dawn C Carr
- Department of Sociology, Florida State University, Tallahassee, Florida, USA
| | - Neil Charness
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA
| | - Walter R Boot
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA
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Calatayud E, Oliván-Blázquez B, Sánchez Peña M, Aguilar-Latorre A, Tena-Bernal O. Cognitive and functional evolution in older adults with and without intellectual disability using a multicomponent intervention: A prospective longitudinal study. Exp Gerontol 2024; 185:112352. [PMID: 38128849 DOI: 10.1016/j.exger.2023.112352] [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: 03/30/2023] [Revised: 10/19/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The global population is experiencing accelerated biopsychosocial aging. Cognitive impairment is frequently associated with functional impairment in basic and instrumental daily living activities. To maintain optimal cognitive and functional functioning, health professionals recommend that older adults participate in cognitive training. AIMS This study examines the cognitive and functional evolution of older adults with and without Intellectual Disability and the factors associated with favourable evolution following the intervention of a multicomponent programme based on the human occupational model and the person-centred care model. METHODS AND PROCEDURES 247 people participated. Descriptive and univariate analyses were performed to examine baseline data. The Wilcoxon paired samples test was used to compare cognitive and functional evolution one year after the intervention. Linear regression was used to detect factors predicting favourable evolution. OUTCOMES AND RESULTS Both populations improved cognitively. There was no change in basic activities of daily living. There was an improvement in instrumental activities of daily living in the group with Intellectual Disability. None of the variables collected was a predictor of greater improvement. CONCLUSIONS AND IMPLICATIONS This study demonstrated that older people with Intellectual Disability who have supports to cope with this life stage can improve their cognitive and functional abilities.
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Affiliation(s)
- Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda, San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda, San Juan Bosco, 13, 50009 Zaragoza, Spain; Department of Psychology and Sociology, Faculty of Social and Labour Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Marta Sánchez Peña
- Aragonese Tutelary Association for Intellectual Disability (ATADES), Sonsoles Residential Centre Termine Miraflores, s / n, 50630 Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda, San Juan Bosco, 13, 50009 Zaragoza, Spain; Department of Psychology and Sociology, Faculty of Human Sciences and Education of Huesca, University of Zaragoza, 22003 Huesca, Spain.
| | - Olga Tena-Bernal
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; Aragonese Tutelary Association for Intellectual Disability (ATADES), Santo Ángel Occupational and Residential Centre, C / Ariza n°8, 50012 Zaragoza, Spain
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Zhang S, Dieciuc M, Dilanchian A, Lustria MLA, Carr D, Charness N, He Z, Boot WR. Adherence Promotion With Tailored Motivational Messages: Proof of Concept and Message Preferences in Older Adults. Gerontol Geriatr Med 2024; 10:23337214231224571. [PMID: 38223550 PMCID: PMC10785722 DOI: 10.1177/23337214231224571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024] Open
Abstract
This study examined the feasibility of using tailored text messages to promote adherence to longitudinal protocols and determined what facets of text message tone influence motivation. Forty-three older adults (Mage = 73.21, SD = 5.37) were recruited to engage in video-game-based cognitive training for 10 consecutive days. Participants received encouraging text messages each morning that matched their highest or lowest ranking reasons for participating in the study, after which they rated how effective each message was in motivating them to play the games that day. After 10 days, participants rated all possible messages and participated in semi-structured interviews to elicit their preferences for these messages. Results showed that messages matching participants' reasons for participating were more motivating than mismatched messages. Further, participants preferred messages that were personalized (i.e., use second person voice) and in formal tones. Messages consistent with these preferences were also rated as more motivating. These findings establish the feasibility of using message tailoring to promote adherence to longitudinal protocols and the relevance of tailoring messages to be personal and formal.
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Affiliation(s)
| | | | | | | | - Dawn Carr
- Florida State University, Tallahassee, USA
| | | | - Zhe He
- Florida State University, Tallahassee, USA
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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.
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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
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12
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Gonnord T, Clarys D, Boucard G, Esnard C. Positive impact of social relationships fostered by physical and/or cognitive group activity on older people's quality of life: PRISMA systematic review. Front Psychol 2023; 14:1166072. [PMID: 37767210 PMCID: PMC10520714 DOI: 10.3389/fpsyg.2023.1166072] [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: 02/14/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction This review identified and examined the research literature on the effect of participating in physical and/or cognitive activities on older people's quality of life, to establish whether the social relationships fostered by these activities can be a vector of better physical, mental and social quality of life. Method A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched four databases (MEDLINE, APA PsycArticles/PsycInfo, PubMed, and Web of Science) for articles published between 1975 and 2022 using search terms related to psychosocial, population, and intervention topics. Studies were eligible if they involved older adults, participation in at least one activity (physical or cognitive), and at least one quality of life related outcome measure. Results We selected 20 articles published between 1990 and 2021, the majority concerning studies conducted in English-speaking countries. Ten studies were interventional (introduction of program of activities), and 10 studies were observational (60% quantitative, 40% qualitative). Overall, results revealed a positive impact of the activities on every aspect of quality of life (i.e., cognitive, physical, social, psychological, and quality of life in general). Conclusion The present review confirmed the beneficial impact of practicing physical and/or cognitive group activities on older people's quality of life, but the contribution of social factors and social relationships remains underestimated and not well defined in researches.
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Affiliation(s)
- Tiphanie Gonnord
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
| | - David Clarys
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
| | - Geoffroy Boucard
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
- Laboratoire Mobilité Vieillissement Exercice (EA6314), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France
| | - Catherine Esnard
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
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Smith ET, Basak C. A game-factors approach to cognitive benefits from video-game training: A meta-analysis. PLoS One 2023; 18:e0285925. [PMID: 37531408 PMCID: PMC10395941 DOI: 10.1371/journal.pone.0285925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/04/2023] [Indexed: 08/04/2023] Open
Abstract
This current study is a meta-analysis conducted on 63 studies on video-game based cognitive interventions (118 investigations, N = 2,079), which demonstrated a moderate and significant training effect on overall gains in cognition, g = 0.25, p < .001. Significant evidence of transfer was found to overall cognition, as well as to attention/perception and higher-order cognition constructs. Examination of specific gameplay features however showed selective and differential transfer to these outcome measures, whereas the genre labels of "action", "strategy", "casual", and "non-casual" were not similarly predictive of outcomes. We therefore recommend that future video-game interventions targeting cognitive enhancements should consider gameplay feature classification approach over existing genre classification, which may provide more fruitful training-related benefits to cognition.
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Affiliation(s)
- Evan T. Smith
- Center for Vital Longevity, University of Texas at Dallas, Dallas, Texas, United States of America
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, United States of America
| | - Chandramallika Basak
- Center for Vital Longevity, University of Texas at Dallas, Dallas, Texas, United States of America
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, United States of America
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Rozenberg D, Shore J, Camacho Perez E, Nourouzpour S, Ibrahim Masthan M, Santa Mina D, Campos JL, Huszti E, Green R, Khan MH, Lau A, Gold D, Stanbrook MB, Reid WD. Feasibility of a Home-Based Cognitive-Physical Exercise Program in Patients With Chronic Obstructive Pulmonary Disease: Protocol for a Feasibility and Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48666. [PMID: 37436794 PMCID: PMC10372770 DOI: 10.2196/48666] [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: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive condition associated with physical and cognitive impairments contributing to difficulty in performing activities of daily living (ADLs) that require dual tasking (eg, walking and talking). Despite evidence showing that cognitive decline occurs among patients with COPD and may contribute to functional limitations and decreased health-related quality of life (HRQL), pulmonary rehabilitation continues to focus mainly on physical training (ie, aerobic and strength exercises). An integrated cognitive and physical training program compared to physical training alone may be more effective in increasing dual-tasking ability among people living with COPD, leading to greater improvements in performance of ADLs and HRQL. OBJECTIVE The aims of this study are to evaluate the feasibility of an 8-week randomized controlled trial of home-based, cognitive-physical training versus physical training for patients with moderate to severe COPD and derive preliminary estimates of cognitive-physical training intervention efficacy on measures of physical and cognitive function, dual task performance, ADLs, and HRQL. METHODS A total of 24 participants with moderate to severe COPD will be recruited and randomized into cognitive-physical training or physical training. All participants will be prescribed an individualized home physical exercise program comprising 5 days of moderate-intensity aerobic exercise (30-50 minutes/session) and 2 days of whole-body strength training per week. The cognitive-physical training group will also perform cognitive training for approximately 60 minutes, 5 days per week via the BrainHQ platform (Posit Science Corporation). Participants will meet once weekly with an exercise professional (via videoconference) who will provide support by reviewing the progression of their training and addressing any queries. Feasibility will be assessed through the recruitment rate, program adherence, satisfaction, attrition, and safety. The intervention efficacy regarding dual task performance, physical function, ADLs, and HRQL will be evaluated at baseline and at 4 and 8 weeks. Descriptive statistics will be used to summarize intervention feasibility. Paired 2-tailed t tests and 2-tailed t tests will be used to compare the changes in the outcome measures over the 8-week study period within and between the 2 randomized groups, respectively. RESULTS Enrollment started in January 2022. It is estimated that the enrollment period will be 24 months long, with data collection to be completed by December 2023. CONCLUSIONS A supervised home-based cognitive-physical training program may be an accessible intervention to improve dual-tasking ability in people living with COPD. Evaluating the feasibility and effect estimates is a critical first step to inform future clinical trials evaluating this approach and its effects on physical and cognitive function, ADL performance, and HRQL. TRIAL REGISTRATION ClinicalTrials.gov NCT05140226; https://clinicaltrials.gov/ct2/show/NCT05140226. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48666.
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Affiliation(s)
- Dmitry Rozenberg
- Respirology and Lung Transplantation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Josh Shore
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | | | - Sahar Nourouzpour
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | | | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada
| | - Jennifer L Campos
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Ella Huszti
- Biostatistics Research Unit, University Health Network, Toronto, ON, Canada
| | - Robin Green
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, ON, Canada
| | | | - Ambrose Lau
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | - David Gold
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Matthew B Stanbrook
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | - W Darlene Reid
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Interdivisional Department of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
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15
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Wen H, Dong Y. The effect of ageing on confrontation naming in healthy older adults: a three-level meta-analysis. JOURNAL OF COGNITIVE PSYCHOLOGY 2023. [DOI: 10.1080/20445911.2023.2184745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Affiliation(s)
- Hao Wen
- Language Processing and Development Lab, School of International Studies, Zhejiang University, Hangzhou, People’s Republic of China
| | - Yanping Dong
- Language Processing and Development Lab, School of International Studies, Zhejiang University, Hangzhou, People’s Republic of China
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Outcomes of a computer-based cognitive training (CoRe) in early phases of cognitive decline: a data-driven cluster analysis. Sci Rep 2023; 13:2175. [PMID: 36750612 PMCID: PMC9905613 DOI: 10.1038/s41598-022-26924-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/21/2022] [Indexed: 02/09/2023] Open
Abstract
The present study aimed to identify clusters of cognitive profiles as well as to explore the effects of these clusters on demographic/individual characteristics and on improvements after a computer-based cognitive training (CCT) in early cognitive impairment. Fifty-seven subjects underwent to an adaptive CCT for 3 weeks (4 individual face-to-face sessions/week of 45 min) and were evaluated at baseline (T0), post-intervention (T1), and after 6 (T2) and 12 (T3) months. Clusters of cognitive profiles were explored with k-means analysis. The analysis revealed two clusters, which were composed by 27 and 30 patients characterized by lower (Cluster 1) and higher (Cluster 2) cognitive functioning. At T1, cognitive performance improved in both groups, but Cluster 1 gained more benefits in global cognitive functioning than Cluster 2. However, at T3, Cluster 2 remained stable in its clinical condition, whereas Cluster 1 showed a pronounced worsening. In conclusion, Cluster 1 profile was associated with a more marked but also short-lasting responsiveness to CCT, whereas patients fitting with Cluster 2 characteristics seemed to obtain more CCT benefits in terms of stability or even delay of cognitive/functional decline. These findings may have relevant implications in informing the timing and modality of delivery of CCT.
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Falkenreck JM, Kunkler MC, Ophey A, Weigert H, Friese A, Jahr P, Nelles G, Kalbe E, Polidori MC. Effects of the Multicomponent Cognitive Training Program BrainProtect in Cognitively Healthy Adults: A Randomized Controlled Trial. J Alzheimers Dis 2023; 94:1013-1034. [PMID: 37393493 DOI: 10.3233/jad-220619] [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: 07/03/2023]
Abstract
BACKGROUND Cognitive integrity is a fundamental driver of health. The exact structure of strategies against cognitive impairment is still under debate. OBJECTIVE To compare the short-term effects of a multicomponent cognitive training (BrainProtect) with those of general health counseling (GHC) on cognitive abilities and health-related quality of life (HRQoL) in healthy adults in Germany. METHODS In this parallel randomized controlled trial (RCT), 132 eligible cognitively healthy adults (age ≥50 years, Beck Depression Inventory ≤9/63; Montreal Cognitive Assessment ≥26/30) were randomized to either GHC (N = 72) or to intervention with BrainProtect (intervention group, IG; N = 60). IG participants received 8 weekly sessions of 90 min of the group-based BrainProtect program focusing on executive functions, concentration, learning, perception, and imagination, plus nutritional and physical exercise units. Before and after intervention, all participants underwent neuropsychological testing and HRQoL evaluation, blinded for pretest. RESULTS No significant training effect was observed for the primary endpoint of global cognition as assessed by CERAD-Plus-z Total Score (p = 0.113; ηp2 = 0.023). Improvements in several cognitive subtests were shown in the IG (N = 53) compared to the GHC (N = 62) without adverse events. Differences reached significance for verbal fluency (p = 0.021), visual memory (p = 0.013), visuo-constructive functions (p = 0.034), and HRQoL (p = 0.009). Significance was lost after adjustment, though several changes were clinically relevant. CONCLUSION BrainProtect did not significantly impact global cognition in this RCT. Nevertheless, the results of some outcomes indicate clinically meaningful changes, so that a strengthening of the cognitive performance by BrainProtect cannot be excluded. Further studies with larger sample size are needed to confirm these findings.
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Affiliation(s)
- Julia Maria Falkenreck
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michelle Celine Kunkler
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anja Ophey
- Department of Medical Psychology ∣ Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Hannah Weigert
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | | | | | - Elke Kalbe
- Department of Medical Psychology ∣ Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - M Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Booth SJ, Brown LJE, Taylor JR, Pobric G. Experimental investigation of training schedule on home-based working memory training in healthy older adults. Front Psychol 2023; 14:1165275. [PMID: 37187566 PMCID: PMC10175577 DOI: 10.3389/fpsyg.2023.1165275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
Introduction The efficacy of working memory training (WMT) for cognitive enhancement in healthy older adults has been extensively investigated. Typically, WMT results in improved performance on the training task, but limited or no transfer of improvement to other cognitive tasks. Accordingly, there is a need to identify optimal intervention parameters to maximize training and transfer task effects of WMT. The current study aimed to investigate the effect of training schedule on training and transfer task performance of WMT in healthy older adults. A secondary aim was to examine the feasibility of participants performing the intervention online at home, unsupervised, and using their personal devices. Methods Participants (N = 71; mean age: 66 years) completed sixteen WMT or active-control sessions over eight (distributed) or four (intensive) weeks. Adaptive verbal and spatial n-back tasks were used as the WMT tasks. We tested near transfer effects to a digit-span task and far transfer effects to an abstract relational reasoning task. Results Participants successfully performed the cognitively demanding intervention using their own devices, online at home, and with minimal contact with the researcher. We observed a significant improvement in WMT task performance in the WMT group relative to active-controls, but no evidence of near or far transfer. Similar training effects were observed irrespective of the intensity of the training schedule. Discussion Our results suggest that comparable benefits could be observed when using less intensive schedules that may be more easily accommodated into everyday life.
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Affiliation(s)
- Samantha J. Booth
- Division of Psychology, Communication, and Human Neuroscience, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Laura J. E. Brown
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Jason R. Taylor
- Division of Psychology, Communication, and Human Neuroscience, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Gorana Pobric
- Division of Psychology, Communication, and Human Neuroscience, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- *Correspondence: Gorana Pobric,
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Phanasathit M, Nimnuan C, Lohsoonthorn V. The Effects of Cognitive Training in Healthy Community Residing Thai Elderly: A Randomized Controlled Trial. Psychol Res Behav Manag 2022; 15:3709-3720. [PMID: 36573088 PMCID: PMC9789711 DOI: 10.2147/prbm.s383526] [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: 08/04/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Cognitive training intervention (CTI) is defined as any mechanism of action of a non-pharmacological procedure provided to improve cognitive function. CTI in healthy elderly has the potential to improve cognitive function; however, the effects of interactive computerized-CTI in old ages have been inconclusive. The present study aimed to determine the effects of low-technology CTI in community-based populations. Patients and Methods The study was a 2-arm parallel single-blinded randomized controlled intervention trial. The main outcome measured global cognitive function utilizing the Thai Mental State Examination (TMSE); the minor outcomes were cognitive subdomains and psychosocial outcomes (ie, quality of life and depression). The primary endpoint assessed the treatment effect at the 12th week (T1), while the secondary endpoint evaluated the carry-over effect at the 24th week (T2). Results Eighty-six eligible participants were recruited from a senior society on the edge of Bangkok. At baseline (T0), the mean age and TMSE score among CTI (n = 44) and wait-list (n = 42) groups were similar (age; 66.66 ± 5.52 and 67.52 ± 6.46; TMSE; 28.84 ± 1.38 and 28.83 ± 1.12, respectively). For the CTI group, the mean number of cognitive training sessions was 14.82 ± 7.62. By using intention-to-treat analysis at the primary endpoint, the mean difference score of TMSE in the CTI group was significantly higher than the wait-list group (∆TMSEbetween group at T1-T0 = 0.57; 95% CI = 0.07 to 1.08), while the effect size was 0.48. At the secondary endpoint, there was no significant difference observed between the CTI and wait-list groups (∆TMSEbetween group at T2-T0 = 0.33; 95% CI = -0.23 to 0.88), while the effect size was 0.25. The cognitive subdomains and psychosocial outcomes were discovered with no significant difference. Conclusion CTI showed significant treatment effect for improvement in global cognitive function in healthy Thai elderly but did not demonstrate carry-over effect. This study provided preliminary evidence of the feasibility of implementing low-technology CTI in middle-income countries.
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Affiliation(s)
- Muthita Phanasathit
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Department of Psychiatry, Center of Excellence in Applied Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Chaichana Nimnuan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Vitool Lohsoonthorn
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Correspondence: Vitool Lohsoonthorn, Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Ratchadamri Road, Pathum Wan, Bangkok, 10330, Thailand, Tel +66 2252 7864; +66 2256 4000 Ext. 3701, Email
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Turnbull A, Seitz A, Tadin D, Lin FV. Unifying framework for cognitive training interventions in brain aging. Ageing Res Rev 2022; 81:101724. [PMID: 36031055 PMCID: PMC10681332 DOI: 10.1016/j.arr.2022.101724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/29/2022] [Accepted: 08/22/2022] [Indexed: 01/31/2023]
Abstract
Cognitive training is a promising tool for slowing or preventing cognitive decline in older adults at-risk for dementia. Its success, however, has been limited by a lack of evidence showing that it reliably causes broad training effects: improvements in cognition across a range of domains that lead to real-world benefits. Here, we propose a framework for enhancing the effect of cognitive training interventions in brain aging. The focus is on (A) developing cognitive training task paradigms that are informed by population-level cognitive characteristics and pathophysiology, and (B) personalizing how these sets are presented to participants during training via feedback loops that aim to optimize "mismatch" between participant capacity and training demands using both adaptation and random variability. In this way, cognitive training can better alter whole-brain topology in a manner that supports broad training effects in the context of brain aging.
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Affiliation(s)
- Adam Turnbull
- University of Rochester, USA; Stanford University, USA
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21
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Sella E, Carbone E, Vincenzi M, Toffalini E, Borella E. Efficacy of memory training interventions targeting metacognition for older adults: a systematic review and meta-analysis. Aging Ment Health 2022; 27:674-694. [PMID: 36218025 DOI: 10.1080/13607863.2022.2122931] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES This review examined the evidence about training interventions targeting metacognition in improving memory and cognitive performance, metacognitive functioning, and well-being in healthy older adults. METHODS Studies were identified in the PsycInfo, PubMed, and Scopus databases. The risk of bias was assessed using tools based on the Joanna Briggs criteria. The data were meta-analyzed using random effects models for those training targeting metacognition alone (metacognitive training) or combined with memory strategy training (strategic metacognitive training). RESULTS Out of the 3,487 articles first identified, 25 studies were eligible for our review (N = 1,768 older adults; mean age range: 64-85 years). Metacognitive training and strategic metacognitive training elicited improvements in memory (d = 0.52 [95% CI: 0.19; 0.84], and d = 0.44 [95% CI: 0.29; 0.58], respectively), metacognitive beliefs (d = 0.58 [95% CI: 0.23; 0.93], and d = 48 [95% CI: 0.28; 0.69], respectively), strategy use (d = 0.98 [95% CI: 0.46; 1.49] and 0.87 [95% CI: 0.14; 1.61], respectively), and memory self-efficacy (d = 0.08 [95% CI: -0.39; 0.56] and 0.55 [95% CI: 0.36; 0.75], respectively). Strategic metacognitive training also improved well-being (d = 0.21 [95% CI: 0.07; 0.35]). CONCLUSION Interventions targeting metacognition (alone or combined with memory strategy training) have the potential to support older adults' memory and metacognitive functioning. The methodological quality of most studies on the topic was often limited, however. Furthermore, well-designed studies needed to confirm the benefits of such interventions in older age.
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Affiliation(s)
- Enrico Sella
- Department of General Psychology, University of Padova, Padova, Italy
| | - Elena Carbone
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Enrico Toffalini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Borella
- Department of General Psychology, University of Padova, Padova, Italy
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22
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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.
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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
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23
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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.
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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: )
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24
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Boutzoukas EM, O'Shea A, Kraft JN, Hardcastle C, Evangelista ND, Hausman HK, Albizu A, Van Etten EJ, Bharadwaj PK, Smith SG, Song H, Porges EC, Hishaw A, DeKosky ST, Wu SS, Marsiske M, Alexander GE, Cohen R, Woods AJ. Higher white matter hyperintensity load adversely affects pre-post proximal cognitive training performance in healthy older adults. GeroScience 2022; 44:1441-1455. [PMID: 35278154 PMCID: PMC9213634 DOI: 10.1007/s11357-022-00538-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022] Open
Abstract
Cognitive training has shown promise for improving cognition in older adults. Age-related neuroanatomical changes may affect cognitive training outcomes. White matter hyperintensities are one common brain change in aging reflecting decreased white matter integrity. The current study assessed (1) proximal cognitive training performance following a 3-month randomized control trial and (2) the contribution of baseline whole-brain white matter hyperintensity load, or total lesion volume (TLV), on pre-post proximal training change. Sixty-two healthy older adults were randomized to either adaptive cognitive training or educational training control interventions. Repeated-measures analysis of covariance revealed two-way group × time interactions such that those assigned cognitive training demonstrated greater improvement on proximal composite (total training composite) and sub-composite (processing speed training composite, working memory training composite) measures compared to education training counterparts. Multiple linear regression showed higher baseline TLV associated with lower pre-post change on processing speed training sub-composite (β = -0.19, p = 0.04), but not other composite measures. These findings demonstrate the utility of cognitive training for improving post-intervention proximal performance in older adults. Additionally, pre-post proximal processing speed training change appears to be particularly sensitive to white matter hyperintensity load versus working memory training change. These data suggest that TLV may serve as an important factor for consideration when planning processing speed-based cognitive training interventions for remediation of cognitive decline in older adults.
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Affiliation(s)
- Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Emily J Van Etten
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Eric C Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Alex Hishaw
- Department Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, USA
- Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Steven T DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Samuel S Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
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25
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Marusic U, Verghese J, Mahoney JR. Does Cognitive Training Improve Mobility, Enhance Cognition, and Promote Neural Activation? Front Aging Neurosci 2022; 14:845825. [PMID: 35677205 PMCID: PMC9168002 DOI: 10.3389/fnagi.2022.845825] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
A close inter-relationship between mobility and cognition is reported in older adults, with improvements in gait performance noticeable after cognitive remediation in frail individuals. The aim of this study was to evaluate the efficacy of computerized cognitive training (CCT) on mobility in healthy, independently living older adults, and to determine whether CCT is associated with changes in neural activation for mobility-related brain processes. Using a randomized single-blind control design, sixty-three non-demented adults age 60 y and older (mean age = 67 y; 76% female, mean Montreal Cognitive Assessment [MoCA] score = 27) were recruited from a local Senior Activity Center. Participants were randomly assigned to either a 2-month CCT program (8 weeks, 3x/week, 40 min/session) or a wait-list control group. Primary outcome was self-selected gait speed during single- and dual-task walking. Secondary outcome was executive function on Trail Making Test (TMT), Part B. Neural activity was assessed via electroencephalography/event-related potentials (EEG/ERPs) targeting lower-limb performance. Results from a linear mixed effect model, adjusted for baseline MoCA score, age, gender, and study completion revealed that compared to controls, CCT improved gait speed during the dual-task (p = 0.008) but not during the single-task walking condition (p = 0.057). CCT also improved executive function (p = 0.024). Further, shorter foot reaction time responses (p = 0.019) were found with enhanced neural activation over sensorimotor areas, with shorter ERP latencies during the P2 component (p = 0.008) and enhanced motor responses (p = 0.009) also evident in the CCT group after the intervention. Overall, the electrophysiological findings suggest possible neural adaptations that could explain improvements in mobility and executive functions associated with CCT in healthy older adults.
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Affiliation(s)
- Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea—ECM, Maribor, Slovenia
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Jeannette R. Mahoney
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
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26
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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.
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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
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27
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Hardcastle C, Hausman HK, Kraft JN, Albizu A, O'Shea A, Boutzoukas EM, Evangelista ND, Langer K, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, Porges E, DeKosky ST, Hishaw GA, Wu SS, Marsiske M, Cohen R, Alexander GE, Woods AJ. Proximal improvement and higher-order resting state network change after multidomain cognitive training intervention in healthy older adults. GeroScience 2022; 44:1011-1027. [PMID: 35258771 PMCID: PMC9135928 DOI: 10.1007/s11357-022-00535-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/18/2022] [Indexed: 01/01/2023] Open
Abstract
Prior randomized control trials have shown that cognitive training interventions resulted in improved proximal task performance, improved functioning of activities of daily living, and reduced dementia risk in healthy older adults. Neural correlates implicated in cognitive training include hub brain regions of higher-order resting state networks including the default mode network, dorsal attention network, frontoparietal control network, and cingulo-opercular network. However, little is known about resting state network change after cognitive training, or the relation between functional brain changes and improvement in proximal task performance. We assessed the 1) change in proximal task performance, 2) change in higher-order resting state network connectivity via functional magnetic resonance imaging, and 3) association between these variables after a multidomain attention/speed-of-processing and working memory randomized control trial in a sample of 58 healthy older adults. Participants in the cognitive training group improved significantly on seven out of eight training tasks immediately after the training intervention with the largest magnitude of improvement in a divided attention/speed-of-processing task, the Double Decision task. Only the frontoparietal control network had significantly strengthened connectivity in the cognitive training group at the post-intervention timepoint. Lastly, higher frontoparietal control network connectivity was associated with improved Double Decision task performance after training in the cognitive training group. These findings show that the frontoparietal control network may strengthen after multidomain cognitive training interventions, and this network may underlie improvements in divided attention/speed-of-processing proximal improvement.
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Affiliation(s)
- Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Kailey Langer
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Emily J Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Steven T DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Samuel S Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA
| | - Gene E Alexander
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1249 Center Drive, PO Box 100196, Gainesville, FL, 32610-0165, USA.
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28
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Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs. Ageing Res Rev 2022; 76:101591. [PMID: 35182742 DOI: 10.1016/j.arr.2022.101591] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine the dose-response relationship between overall and specific types of exercise with cognitive function in older adults. DESIGN Systematic Review and Bayesian Model-Based Network Meta-Analysis. DATA SOURCES Systematic search of MEDLINE, Web of Science, Scopus, PsycINFO and SPORTDiscus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomized controlled trials of exercise interventions in participants aged 50 years or over, and that reported on at least one global cognition outcome. RESULTS The search returned 1998 records, of which 44 studies (4793 participants; 102 different effect sizes) were included in this review with meta-analysis. There was a non-linear, dose-response association between overall exercise and cognition. We found no minimal threshold for the beneficial effect of exercise on cognition. The estimated minimal exercise dose associated with clinically relevant changes in cognition was 724 METs-min per week, and doses beyond 1200 METs-min per week provided less clear benefits. We also found that the dose-response association was exercise type dependent, and our results show that clinically important effects may occur at lower doses for many types of exercise. Our findings also highlighted the superior effects of resistance exercises over other modalities. CONCLUSIONS If provided with the most potent modalities, older adults can get clinical meaningful benefits with lower doses than the WHO guidelines. Findings support the WHO recommendations to emphasise resistance training as a critical component of interventions for older adults.
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Brief Strategy Training in Aging: Near Transfer Effects and Mediation of Gains by Improved Self-Regulation. Brain Sci 2022; 12:brainsci12040465. [PMID: 35447995 PMCID: PMC9027409 DOI: 10.3390/brainsci12040465] [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: 03/02/2022] [Revised: 03/18/2022] [Accepted: 03/26/2022] [Indexed: 12/10/2022] Open
Abstract
A common approach to cognitive intervention for adults is memory strategy training, but limited work of this type has examined intervention effects in relation to self-regulation (e.g., strategy usage, memory beliefs) and few have established near transfer (training-related performance gain on untrained tasks related to the target task). The present research, Everyday Memory Clinic—Revised (EMC-R), examined whether relatively brief face-name association training, offering elements focused on self-regulation, can improve name recall, enhance memory self-regulation, and lead to near transfer. Participants were 122 healthy, well-educated middle-aged and older adults (51–90 years old) randomly assigned to a strategy training program (SO), a comparable program with a theoretical self-regulatory boost (SB), or a waitlist control group. Compared to the waitlist group, both groups of trainees demonstrated higher pretest-posttest improvements in name recall (target task), memory self-efficacy, and effective strategy use, as well as the near transfer of gains to nontrained associative tasks, a rare finding in strategy training research. Furthermore, changes in memory self-efficacy and strategy use fully mediated the effect of training on name recall. This innovative approach for brief memory intervention offers a model for successful training that can be easily disseminated via community centers and lifelong learning programs.
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Feasibility of a Home-Based Task-Switching Training in Middle-Aged Caregivers. JOURNAL OF COGNITIVE ENHANCEMENT 2022; 6:295-315. [PMID: 35966367 PMCID: PMC9360113 DOI: 10.1007/s41465-021-00237-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/09/2021] [Indexed: 11/01/2022]
Abstract
AbstractThe current study aimed at investigating feasibility of a self-administered task-switching training in a middle-aged working population. Eighty-one caregivers (41–62 years old) were instructed to train at home 8 times either within a 7- or 14-day interval. Only 56.7% performed more than 50% of the instructed number of training sessions. However, compliant caregivers (who completed more than 4 training sessions) showed significant training gains and transfer to an untrained task-switching task. Although transfer effects to other cognitive tasks were not found, trained participants tended to report fewer everyday memory failures than a control group. In conclusion, the implementation of a home-based task-switching training in everyday life of caregivers is possible. However, there is only limited evidence for generalization of results of previous laboratory studies. Adherence and transfer to other cognitive tasks are discussed as important challenges in conveying laboratory findings into real life.
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Manser P, de Bruin ED. Making the Best Out of IT: Design and Development of Exergames for Older Adults With Mild Neurocognitive Disorder - A Methodological Paper. Front Aging Neurosci 2021; 13:734012. [PMID: 34955806 PMCID: PMC8698204 DOI: 10.3389/fnagi.2021.734012] [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: 06/30/2021] [Accepted: 11/03/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Utilizing information technology (IT) systems, for example in form of computerized cognitive screening or exergame-based (also called active videogames) training, has gained growing interest for supporting healthy aging and to detect, prevent and treat neurocognitive disorders (NCD). To ameliorate the effectiveness of exergaming, the neurobiological mechanisms as well as the most effective components for exergame-based training remain to be established. At the same time, it is important to account for the end-users' capabilities, preferences, and therapeutic needs during the design and development process to foster the usability and acceptance of the resulting program in clinical practice. This will positively influence adherence to the resulting exergame-based training program, which, in turn, favors more distinct training-related neurobiological effects. Objectives and Methods: This methodological paper describes the design and development process of novel exergame-based training concepts guided by a recently proposed methodological framework: The 'Multidisciplinary Iterative Design of Exergames (MIDE): A Framework for Supporting the Design, Development, and Evaluation of Exergames for Health' (Li et al., 2020). Case Study: A step-by-step application of the MIDE-framework as a specific guidance in an ongoing project aiming to design, develop, and evaluate an exergame-based training concept with the aim to halt and/or reduce cognitive decline and improve quality of life in older adults with mild neurocognitive disorder (mNCD) is illustrated. Discussion and Conclusion: The development of novel exergame-based training concepts is greatly facilitated when it is based on a theoretical framework (e.g., the MIDE-framework). Applying this framework resulted in a structured, iterative, and evidence-based approach that led to the identification of multiple key requirements for the exergame design as well as the training components that otherwise may have been overlooked or neglected. This is expected to foster the usability and acceptance of the resulting exergame intervention in "real life" settings. Therefore, it is strongly recommended to implement a theoretical framework (e.g., the MIDE-framework) for future research projects in line with well-known checklists to improve completeness of reporting and replicability when serious games for motor-cognitive rehabilitation purposes are to be developed.
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Affiliation(s)
- Patrick Manser
- Movement Control and Learning - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D de Bruin
- Movement Control and Learning - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,OST - Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
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Nouchi R, Nouchi H, Dinet J, Kawashima R. Cognitive Training with Neurofeedback Using NIRS Improved Cognitive Functions in Young Adults: Evidence from a Randomized Controlled Trial. Brain Sci 2021; 12:brainsci12010005. [PMID: 35053748 PMCID: PMC8774006 DOI: 10.3390/brainsci12010005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: A previous study has shown that cognitive training with neurofeedback (CT-NF) using down-regulation improves cognitive functions in young adults. Neurofeedback has two strategies for manipulating brain activity (down-regulation and upregulation). However, the benefit of CT-NF with the upregulation of cognitive functions is still unknown. In this study, we investigated whether the upregulation of CT-NF improves a wide range of cognitive functions compared to cognitive training alone. (2) Methods: In this double-blinded randomized control trial (RCT), 60 young adults were randomly assigned to one of three groups: CT-NF group, CT alone group, and an active control (ACT) group who played a puzzle game. Participants in the three groups used the same device (tablet PC and 2ch NIRS (near-infrared spectroscopy)) and performed the training game for 20 min every day for four weeks. We measured brain activity during training in all groups, but only CT-NFs received NF. We also measured a wide range of cognitive functions before and after the intervention period. (3) Results: The CT-NF groups showed superior beneficial effects on episodic memory, working memory, and attention compared to the CT alone and ACT groups. In addition, the CT-NF group showed an increase in brain activity during CT, which was associated with improvements in cognitive function. (4) Discussion: This study first demonstrated that the CT-NF using the upregulation strategy has beneficial effects on cognitive functions compared to the CT alone. Our results suggest that greater brain activities during CT would enhance a benefit from CT.
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Affiliation(s)
- Rui Nouchi
- Department of Cognitive Health Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan;
- Smart Aging Research Center (S.A.R.C.), Tohoku University, Seiryo-Machi 4-1, Sendai 980-8575, Japan;
- Correspondence:
| | - Haruka Nouchi
- Department of Cognitive Health Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan;
| | - Jerome Dinet
- Department of Psychology, Université de Lorraine, F-54000 Nancy, France;
- Lorraine Research Laboratory in Computer Science and Its Applications (LORIA), Université de Lorraine, CNRS, INRIA, F-54000 Nancy, France
| | - Ryuta Kawashima
- Smart Aging Research Center (S.A.R.C.), Tohoku University, Seiryo-Machi 4-1, Sendai 980-8575, Japan;
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan
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Whitfield T, McConnell B, Renouf P, Mansour H, Zabihi S, Aguirre E, Walker Z, Cooper C, Marchant NL. The effect of remotely delivered lifestyle interventions on cognition in older adults without dementia: A systematic review and meta-analysis. Ageing Res Rev 2021; 72:101505. [PMID: 34757173 PMCID: PMC9761296 DOI: 10.1016/j.arr.2021.101505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 01/04/2023]
Abstract
Up to 40% of dementias may be preventable via risk factor modification. This inference has motivated the development of lifestyle interventions for reducing cognitive decline. Typically delivered to older adults face-to-face, the COVID-19 pandemic has necessitated their adaptation for remote delivery. We systematically reviewed randomized controlled trials of remotely delivered lifestyle interventions (≥4 weeks duration and delivered >50% remotely), for adults aged ≥ 60 without dementia, examining effects on objective cognitive measures. Comparators were active (face-to-face or remote) or passive. Ten studies (n = 2967) comprising multidomain (k = 4), physical activity (k = 3) or psychosocial (k = 3) remote interventions were included. Data were synthesized using robust variance estimation meta-analysis. The pooled estimate comparing the effect of remote interventions versus comparators on cognition was not significant (g=-0.02; 95%CI [-0.14, 0.09]; p = .66); subgroup analyses by type of intervention or comparator also yielded non-significant effects. Most studies had low risk of bias. Current evidence to support remote lifestyle interventions is limited. Included studies were conducted pre-pandemic, and evaluated individual, rather than group interventions. Future studies may exploit the greater digital connectivity of older people since the pandemic. Group formats, more frequently efficacious than individual interventions in face-to-face dementia prevention trials, may be a rational approach for future remote trials.
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Affiliation(s)
- Tim Whitfield
- Division of Psychiatry, University College London, London, UK
| | | | - Philippa Renouf
- Division of Psychiatry, University College London, London, UK
| | - Hassan Mansour
- Division of Psychiatry, University College London, London, UK,Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sedigheh Zabihi
- Division of Psychiatry, University College London, London, UK
| | - Elisa Aguirre
- Department of Clinical, Educational and Health Psychology, University College London, London, UK,North East London Mental Health Foundation Trust, London, UK
| | - Zuzana Walker
- Division of Psychiatry, University College London, London, UK,Essex Partnership University NHS Foundation Trust, Essex, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK,Camden and Islington NHS Foundation Trust, London, UK
| | - Natalie L. Marchant
- Division of Psychiatry, University College London, London, UK,Correspondence to: Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
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Vogel O, Niederer D, Vogt L. Multimodal Exercise Effects in Older Adults Depend on Sleep, Movement Biography, and Habitual Physical Activity: A Randomized Controlled Trial. Front Aging Neurosci 2021; 13:722799. [PMID: 34744686 PMCID: PMC8570408 DOI: 10.3389/fnagi.2021.722799] [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: 06/09/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The promotion of healthy aging is one of the major challenges for healthcare systems in current times. The present study investigates the effects of a standardized physical activity intervention for older adults on cognitive capacity, self-reported health, fear of falls, balance, leg strength and gait under consideration of movement biography, sleep duration, and current activity behavior. Methods: This single-blinded, randomized controlled trial included 49 community-dwelling older adults (36 women; 82.9 ± 4.5 years of age (Mean [M] ± SD); intervention group = 25; control group = 24). Movement biography, sleep duration, cognitive capacity, self-reported health status, and fear of falls were assessed by means of questionnaires. Leg strength, gait, and current activity levels were captured using a pressure plate, accelerometers, and conducting the functional-reach and chair-rising-test. The multicomponent intervention took place twice a week for 45 min and lasted 16 weeks. Sub-cohorts of different sleep duration were formed to distinguish between intervention effects and benefits of healthy sleep durations. Change scores were evaluated in univariate analyses of covariances (ANCOVAs) between groups and sub-cohorts of different sleep duration in both groups. Changes in cognitive capacity, self-reported health, fear of falls, balance, leg strength, and gait were investigated using the respective baseline values, movement biography, and current activity levels as covariates. Analysis was by intention-to-treat (ITT). Results: We found sub-cohort differences in cognitive capacity change scores [F (3,48) = 5.498, p = 0.003, ηp 2 = 0.287]. Effects on fear of falls [F (1,48) = 12.961, p = 0.001, ηp 2 = 0.240] and balance change scores F (1,48) = 4.521, p = 0.040, ηp 2 = (0.099) were modified by the level of current activity. Effects on gait cadence were modified by the movement biography [F (1,48) = 4.545; p = 0.039, ηp 2 = 0.100]. Conclusions: Unlike for functional outcomes, our multicomponent intervention in combination with adequate sleep duration appears to provide combinable beneficial effects for cognitive capacity in older adults. Trainability of gait, fear of falls, and flexibility seems to be affected by movement biography and current physical activity levels. Trial registration: This study was registered at the DRKS (German Clinical Trials Register) on November 11, 2020 with the corresponding trial number: DRKS00020472.
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Affiliation(s)
- Oliver Vogel
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Johann Wolfgang Goethe-University, Frankfurt, Germany
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35
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Masika GM, Yu DSF, Li PWC, Lee DTF, Nyundo A. Visual art therapy and cognition: Effects on people with mild cognitive impairment and low education level. J Gerontol B Psychol Sci Soc Sci 2021; 77:1051-1062. [PMID: 34536278 DOI: 10.1093/geronb/gbab168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The aim of this study was to examine the effects of visual art therapy (VAT) on cognition, psychological and functional ability of people with mild cognitive impairment (MCI) and low education. METHOD A single-blinded randomized controlled trial was conducted among 127 older adults with MCI, mean age 73.6 years and level of education in years, (median (range)) = 0 (0 - 9). The intervention group received 12 VAT sessions over six weeks. The control group received six health education sessions. The outcomes measures at baseline, immediately after intervention, at three-months and six-month follow up included global cognitive functions, depression, mental wellbeing and instrumental activities of daily living functions. RESULTS The intervention group demonstrated greater improvement than the control group in global cognition (β =2.56, (95% CI =1.16, 3.97), p< .001, standardized mean difference (SMD) = 0.75), and depression (β =-2.01, (95% CI =-3.09, -0.93), p< .001, SMD = -0.93) immediately post intervention. The effects on cognitive functions were sustained at three and six-months follow ups. The differential effect of VAT on mental wellbeing and functional ability compared to health education were undetectable. DISCUSSION Visual art therapy can improve cognitive functions and mood status of older adults with MCI who have no or low education.
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Affiliation(s)
- Golden M Masika
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong.,Department of Clinical Nursing, School of Nursing and Public Health, University of Dodoma, Tanzania
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Polly W C Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Diana T F Lee
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong
| | - Azan Nyundo
- Department of Psychiatry, School of Medicine and Dentistry, University of Dodoma, Tanzania
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The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis. Neuropsychol Rev 2021; 32:677-702. [PMID: 34350544 PMCID: PMC9381612 DOI: 10.1007/s11065-021-09519-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies (n = 2,931) were included, of which 45 (n = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p-values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].
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Manser P, Thalmann M, Adcock M, Knols RH, de Bruin ED. Can Reactivity of Heart Rate Variability Be a Potential Biomarker and Monitoring Tool to Promote Healthy Aging? A Systematic Review With Meta-Analyses. Front Physiol 2021; 12:686129. [PMID: 34393813 PMCID: PMC8359814 DOI: 10.3389/fphys.2021.686129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/29/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Monitoring phasic responses of heart rate variability (HRV) in terms of HRV reactivity [i. e., the absolute change from resting state to on-task (i.e., absolute values of HRV measured during exercise)] might provide useful insights into the individual psychophysiological responses of healthy middle-aged to older adults (HOA) to cognitive and physical exercises. Objectives: To summarize the evidence of phasic HRV responses to cognitive and physical exercises, and to evaluate key moderating factors influencing these responses. Methods: A systematic review with meta-analyses was performed. Publications up to May 2020 of the databases Medline (EBSCO), Embase, Cochrane Library, CINAHL, Psycinfo, Web of Science, Scopus, and Pedro were considered. Controlled clinical trials and observational studies measuring phasic HRV responses to cognitive and/or physical exercises in HOA (≥50 years) were included. Results: The initial search identified 6,828 articles, of which 43 were included into the systematic review. Compared to resting state, vagally-mediated HRV indices were significantly reduced during all types of exercises [Hedge's g = -0.608, 95 % CI (-0.999 to -0.218), p = 0.002] indicating a significant parasympathetic withdrawal compared to rest. The key moderating variables of these responses identified included exercise intensity for physical exercises, and participant characteristics (i.e., level of cognitive functioning, physical fitness), task demands (i.e., task complexity and modality) and the individual responses to these cognitive challenges for cognitive exercises. In particular, higher task demands (task complexity and physical exercise intensity) were related to larger HRV reactivities. Better physical fitness and cognition were associated with lower HRV reactivities. Additionally, HRV reactivity appeared to be sensitive to training-induced cognitive and neural changes. Conclusion: HRV reactivity seems to be a promising biomarker for monitoring internal training load and evaluating neurobiological effects of training interventions. Further research is warranted to evaluate the potential of HRV reactivity as a monitoring parameter to guide cognitive-motor training interventions and/or as a biomarker for cognitive impairment. This may facilitate the early detection of cognitive impairment as well as allow individualized training adaptations that, in turn, support the healthy aging process by optimizing individual exercise dose and progression of cognitive-motor training.
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Affiliation(s)
- Patrick Manser
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Melanie Thalmann
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Manuela Adcock
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Ruud H Knols
- Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital of Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Liu M, Qian Q, Wang W, Chen L, Wang L, Zhou Y, Xu S, Wu J, Feng T, Zhu Z, Xiang J. Improvement in Language Function in Patients with Aphasia using Computer-Assisted Executive Function Training: A Controlled Clinical Trial. PM R 2021; 14:913-921. [PMID: 34310072 DOI: 10.1002/pmrj.12679] [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] [Received: 06/22/2020] [Revised: 06/13/2021] [Accepted: 07/02/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Non-verbal cognitive training has gained popularity for the management of aphasia. The correlation between language function and cognitive control has been explored previously. Cognitive status affects language to a certain degree. In this study, we aimed to determine whether non-verbal computer-assisted executive control training (CAET) to improve cognitive status affects language performance in patients with aphasia (PWA). DESIGN A total of 73 participants were included in the study, and 5 subjects dropped out. A total of 68 individuals were randomly divided into two groups and underwent treatment. The experimental group was treated with traditional speech and language therapy (SLT) combined with CAET. The control group underwent SLT only. RESULTS Differences between pre- and post-treatment language outcomes expect oral naming (group × time, P = 0.236) were significantly greater in the experimental group compared with the control group: Spontaneous speech (group × time, P = 0.026), Auditory Comprehension (group × time, P < 0.001), Speech repetition (group × time, P = 0.001), AQ (group × time, P < 0.001). A similar effect was observed for cognitive function such as TMT-A (group × time, P = 0.006), TMT-B (group × time, P = 0.005) and VFT-V (group × time, P = 0.018). CONCLUSION Our study demonstrates that CAET combined with SLT can yield favorable language outcomes for PWA, especially improvements in auditory comprehension and AQ. CAET combined with SLT generates benefits in both cognitive function and language performance. Therefore, CAET may be applied as an adjuvant aphasia therapy in conjunction with traditional SLT. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mengting Liu
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Medical Technology School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Qiuchen Qian
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Medical Technology School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Wang
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Medical Technology School, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Lu Chen
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Lingmin Wang
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yeqing Zhou
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Siwei Xu
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jie Wu
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Tao Feng
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zude Zhu
- School of Linguistic Sciences and Arts, Jiangsu Normal University, Xuzhou, China
| | - Jie Xiang
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Medical Technology School, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Bernini S, Panzarasa S, Barbieri M, Sinforiani E, Quaglini S, Tassorelli C, Bottiroli S. A double-blind randomized controlled trial of the efficacy of cognitive training delivered using two different methods in mild cognitive impairment in Parkinson's disease: preliminary report of benefits associated with the use of a computerized tool. Aging Clin Exp Res 2021; 33:1567-1575. [PMID: 32895890 DOI: 10.1007/s40520-020-01665-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/18/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The effectiveness of computer-based cognitive training (CCT) remains controversial, especially in older adults with neurodegenerative diseases. AIMS To evaluate the efficacy of CCT in patients with Parkinson's disease and mild cognitive impairment (PD-MCI). METHODS In this randomized controlled trial, 53 patients were randomized to receive CCT delivered by means of CoRe software, traditional paper-and-pencil cognitive training (PCT), or an unstructured activity intervention (CG). In each group, the intervention lasted 3 consecutive weeks (4 individual face-to-face sessions/week). Neuropsychological assessment was administered at baseline (T0) and post-intervention (T1). Outcome measures at T0 and T1 were compared within and between groups. The Montreal Overall Cognitive Assessment (MoCA) was taken as the primary outcome measure. RESULTS Unlike the PCT group and the CG, the patients receiving CCT showed significant medium/large effect size improvements in MoCA performance, global cognition, executive functions, and attention/processing speed. No baseline individual/demographic variables were associated with greater gains from the intervention, although a negative correlation with baseline MoCA performance was found. CONCLUSION CCT proved effective in PD-MCI patients when compared with traditional PCT. Further follow-up assessments are being conducted to verify the retention of the gains and the potential ability of the tool to delay conversion to PD-dementia. Trial registration number (ClinicalTrials.gov): NCT04111640 (30th September 2019).
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Affiliation(s)
| | - Silvia Panzarasa
- Dept. of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | | | | | - Silvana Quaglini
- Dept. of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- IRCCS Mondino Foundation, Pavia, Italy
- Dept. of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sara Bottiroli
- IRCCS Mondino Foundation, Pavia, Italy
- Giustino Fortunato University, Benevento, Italy
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40
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Yuan F, Klavon E, Liu Z, Lopez RP, Zhao X. A Systematic Review of Robotic Rehabilitation for Cognitive Training. Front Robot AI 2021; 8:605715. [PMID: 34046433 PMCID: PMC8144708 DOI: 10.3389/frobt.2021.605715] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 04/06/2021] [Indexed: 12/16/2022] Open
Abstract
A large and increasing number of people around the world experience cognitive disability. Rehabilitation robotics has provided promising training and assistance approaches to mitigate cognitive deficits. In this article, we carried out a systematic review on recent developments in robot-assisted cognitive training. We included 99 articles in this work and described their applications, enabling technologies, experiments, and products. We also conducted a meta analysis on the articles that evaluated robot-assisted cognitive training protocol with primary end users (i.e., people with cognitive disability). We identified major limitations in current robotics rehabilitation for cognitive training, including the small sample size, non-standard measurement of training and uncontrollable factors. There are still multifaceted challenges in this field, including ethical issues, user-centered (or stakeholder-centered) design, the reliability, trust, and cost-effectiveness, personalization of the robot-assisted cognitive training system. Future research shall also take into consideration human-robot collaboration and social cognition to facilitate a natural human-robot interaction.
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Affiliation(s)
- Fengpei Yuan
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Elizabeth Klavon
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Ziming Liu
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Ruth Palan Lopez
- School of Nursing, MGH Institute of Health Professions, Boston, MA, United States
| | - Xiaopeng Zhao
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, Knoxville, TN, United States
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Increasing autonomy through improved care: effects of a professional care-giver training programme on the functional status of older adults. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The aim of the present research was to evaluate the effectiveness of a care-giver training programme that trains professional care-givers in cognitive stimulation strategies for functional maintenance in care-dependent older adults. The sample contained 69 older adults (37 in the treatment group, 32 control group) assessed with the Barthel Index, the Mini-Mental State Examination and the Clifton Assessment Procedure for the Elderly (Cognitive Scale). Participants in the treatment group were treated by professional care-givers who were trained with the programme CUIDA-2 in communication and cognitive stimulation strategies. The results from the Barthel Index showed significant differences in the post-intervention assessment and in the follow-up assessment, where the treatment group obtained higher scores, and there were significant differences within the treatment group between the initial assessment and the post-treatment assessment, as well as between the initial assessment and the follow-up. The data obtained reflect that a training programme to train professional care-givers produced functional benefits in the older adults, and these improvements persisted over time. Moreover, the care-givers saw themselves as more competent and more satisfied with their work.
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Duda BM, Sweet LH. Functional brain changes associated with cognitive training in healthy older adults: A preliminary ALE meta-analysis. Brain Imaging Behav 2021; 14:1247-1262. [PMID: 30900077 DOI: 10.1007/s11682-019-00080-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Accumulating evidence suggests that cognitive training (CT) programs may provide healthy older adults (OAs) with cognitive benefits that are accompanied by alterations in neural activity. The current review offers the first quantitative synthesis of the available literature on the neural effects of CT in healthy aging. It was hypothesized that OAs would evidence increased and decreased neural activations across various challenging CTs, and that these effects would be observed as significantly altered clusters within regions of the frontoparietal network (FPN). Online databases and reference lists were searched to identify peer-reviewed publications that reported assessment of neural changes associated with CT programs in healthy OAs. Among the 2097 candidate studies identified, 14 studies with a total of 238 participants met inclusionary criteria. GingerALE software was used to quantify neural effects in a whole-brain analysis. The activation likelihood estimation technique revealed significant increases in activation following CT in the left hemisphere middle frontal gyrus, precentral gyrus, and posterior parietal cortex, extending to the superior occipital gyrus. Two clusters of diminished neural activity following CT were identified within the right hemisphere middle frontal gyrus and supramarginal gyrus, extending to the superior temporal gyrus. These results provide preliminary evidence of common neural effects of different CT interventions within regions of the FPN. Findings may inform future investigations of neuroplasticity across the lifespan, including clinical applications of CT, such as assessing treatment outcomes.
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Affiliation(s)
- Bryant M Duda
- Department of Psychology, University of Georgia, Athens, GA, 30602-3001, USA.
| | - Lawrence H Sweet
- Department of Psychology, University of Georgia, Athens, GA, 30602-3001, USA.,Department of Psychiatry & Human Behavior, Brown University Medical School, Providence, RI, USA
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The Effect of Cognitive Intervention on Cognitive Function in Older Adults With Alzheimer's Disease: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 32:247-273. [PMID: 33893905 DOI: 10.1007/s11065-021-09486-4] [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] [Received: 06/18/2019] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
Cognitive intervention includes cognitive stimulation, cognitive training, and cognitive rehabilitation. This systematic review was performed to re-assess the efficacy of cognitive intervention for the patients with Alzheimer's disease (AD). Twenty studies (2012 participants) were eventually included. For global cognitive function, the combined mean difference (MD) in eight studies was 1.67 (95% Confidence Interval: 0.45, 2.89, p = 0.007; Q = 33.28, df = 8, p < 0.0001, τ2 = 2.17, I2 = 76%) for the short term. The pooled standardized mean difference (SMD) of six RCTs was 1.61 (95% Confidence Interval: 0.65, 2.56, p = 0.0009; Q = 127.66, df = 6, p < 0.00001, τ2 = 1.56, I2 = 95%) for the medium term. The pooled SMD of seven studies was 0.79 (95% Confidence Interval: 0.33, 1.25, p = 0.0008; Q = 35.10, df = 7, p < 0.0001, τ2 = 0.33, I2 = 80%) for the long term. For depression, the pooled SMD of two trials was -0.48 (95% Confidence Interval: -0.71, -0.24; p < 0.0001, I2 = 4%) for the short term. Cognitive training may show obvious improvements in global cognitive function whether after short, medium, or long-term interventions and in depression after short term intervention. However, the positive effect of the intervention on general cognitive function or depression did not seem to persist after intervention ended. There is still a lack of reliable and consistent conclusions relevant to the effect of cognitive stimulation and cognitive rehabilitation on observed outcomes, cognitive training for memory or other non-cognitive outcomes. PROSPERO registration number: CRD42019121768.
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44
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Lee HK, Kent JD, Wendel C, Wolinsky FD, Foster ED, Merzenich MM, Voss MW. Home-Based, Adaptive Cognitive Training for Cognitively Normal Older adults: Initial Efficacy Trial. J Gerontol B Psychol Sci Soc Sci 2021; 75:1144-1154. [PMID: 31140569 DOI: 10.1093/geronb/gbz073] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES We examined whether a home-based, adaptive cognitive training (CT) program would lead to cognitive performance changes on a neuropsychological test battery in cognitively normal older adults. METHOD Sixty-eight older adults (age = 70.0, SD = 3.74) were randomly assigned to either CT or an active control group (AC, casual computer games). Participants were instructed to train on their assigned programs for 42 min per day, 5 days per week, over 10 weeks (35 hr of total program usage). Participants completed tests of processing speed, working memory, and executive control before and after 10 weeks of training. RESULTS Training groups did not differ in performance before training. After training, CT participants out-performed AC participants in the overall cognitive composite score, driven by processing speed and working memory domains. DISCUSSION Our results show that a limited dose of home-based CT can drive cognitive improvements as measured with neuropsychological test battery, suggesting potential cognitive health maintenance implications for cognitively normal older adults.
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Affiliation(s)
- Hyun Kyu Lee
- Department of Research and Development, Posit Science Inc., San Francisco, California
| | - James D Kent
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa
| | - Christopher Wendel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa
| | - Fredric D Wolinsky
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa
| | - Eric D Foster
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa
| | - Michael M Merzenich
- Department of Research and Development, Posit Science Inc., San Francisco, California
| | - Michelle W Voss
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa.,Department of Psychological and Brain Sciences, University of Iowa, Iowa
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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.
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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
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46
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Hou J, Jiang T, Fu J, Su B, Wu H, Sun R, Zhang T. The Long-Term Efficacy of Working Memory Training in Healthy Older Adults: A Systematic Review and Meta-Analysis of 22 Randomized Controlled Trials. J Gerontol B Psychol Sci Soc Sci 2021; 75:e174-e188. [PMID: 32507890 DOI: 10.1093/geronb/gbaa077] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The long-lasting efficacy of working memory (WM) training has been a controversial and still ardently debated issue. In this meta-analysis, the authors explored the long-term effects of WM training in healthy older adults on WM subdomains and abilities outside the WM domain assessed in randomized controlled studies. METHOD A systematic literature search of PubMed, Web of Science, PsycINFO, Cochrane Library, ProQuest, clinicaltrials.gov, and Google Scholar was conducted. Random-effects models were used to quantitatively synthesize the existing data. RESULTS Twenty-two eligible studies were included in the meta-analysis. The mean participant age ranged from 63.77 to 80.1 years. The meta-synthesized long-term effects on updating were 0.45 (95% confidence interval = 0.253-0.648, <6 months: 0.395, 0.171-0.619, ≥6 months: 0.641, 0.223-1.058), on shifting, 0.447 (0.246-0.648, <6 months: 0.448, 0.146-0.75, ≥6 months: 0.446, 0.176-0.716); on inhibition, 0.387 (0.228-0.547, <6 months: 0.248, 0.013-0.484, ≥6 months: 0.504, 0.288-0.712); on maintenance, 0.486 (0.352-0.62, <6 months: 0.52, 0.279-0.761, ≥6 months: 0.471, 0.31-0.63). DISCUSSION The results showed that WM training exerted robust long-term effects on enhancing the WM system and improving processing speed and reasoning in late adulthood. Future studies are needed to use different tasks of the same WM construct to evaluate the WM training benefits, to adopt more ecological tasks or tasks related to daily life, to improve the external validity of WM training, and to identify the optimal implementation strategy for WM training.
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Affiliation(s)
- Jianhua Hou
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Taiyi Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China
| | - Jiangning Fu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China
| | - Runsong Sun
- Department of Sociology and Social Work, School of Sociology, Beijing Normal University, China.,National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
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Turowicz A, Czapiga A, Malinowski M, Majcherek J, Litarski A, Janczak D. Carotid Revascularization Improves Cognition in Patients With Asymptomatic Carotid Artery Stenosis and Cognitive Decline. Greater Improvement in Younger Patients With More Disordered Neuropsychological Performance. J Stroke Cerebrovasc Dis 2021; 30:105608. [PMID: 33461024 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105608] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/24/2020] [Accepted: 01/02/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES There has been a growing interest in whether carotid revascularization may reverse cognitive decline. In this study the aim was to assess cognitive changes after carotid artery endarterectomy and stenting, using neuropsychological assessment with MoCA and CANTAB test. MATERIALS AND METHODS Seventy patients with asymptomatic carotid artery stenosis, qualified for CEA (study group A) and CAS (study group B) have been prospectively assessed. 20 patients with lower extremity artery disease (control group C) and 15 patients qualified for inguinal hernia surgery (control group D) have served as a control group. Patients have been evaluated 1 day before surgery and 6 months after, using MoCA and CANTAB test. Logistic regression models were built to determine variables affecting cognitive performance. RESULTS After the procedure in the study group A the cognitive evaluation showed improvement in 5 cognitive domains tested in MoCA: visuospatial/executive (p=.0496), naming (p=.0831), language (p=.0009), abstraction (p=.0126) and delayed recall (p=.0016). In CANTAB there were improvement in PAL (p=.0290) and SWM (p=.0105). In study group B positive cognitive changes were seen in visuospatial/executive (p=.0827) and delayed recall (p=.0041) tested with MoCA and in PAL (PALFAMS28 p=.0315, PALNPR28 p=.0090, PALTEA28 p=.0058) and SWM (p=.0882) tested with CANTAB. Using a regression model, the only strong predictors of cognitive improvement on the follow-up visit were younger age and lower MoCA score on the first visit. CONCLUSIONS Carotid revascularization, both open and endovascular, lead to cognitive improvement in patients with severe carotid stenosis and cognitive decline. This effect seems to be stronger in younger patients with worst cognitive performance before surgery.
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Affiliation(s)
- Agnieszka Turowicz
- Department of Vascular Surgery, 4th Military Teaching Hospital, 5 Weilga street, 50-981 Wrocław, Poland; Department of Vascular, General and Transplant Surgery, Faculty of Medicine, Wrocław Medical University, 213 Borowska street, 50-556 Wrocław, Poland.
| | - Alina Czapiga
- Institute of Psychology, University of Wroclaw, 1 Dawida street, 50-529 Wrocław, Poland.
| | - Maciej Malinowski
- Department of Vascular, General and Transplant Surgery, Faculty of Medicine, Wrocław Medical University, 213 Borowska street, 50-556 Wrocław, Poland.
| | - Jarosław Majcherek
- Department of Vascular Surgery, 4th Military Teaching Hospital, 5 Weilga street, 50-981 Wrocław, Poland.
| | - Andrzej Litarski
- Department of Vascular Surgery, 4th Military Teaching Hospital, 5 Weilga street, 50-981 Wrocław, Poland.
| | - Dariusz Janczak
- Department of Vascular, General and Transplant Surgery, Faculty of Medicine, Wrocław Medical University, 213 Borowska street, 50-556 Wrocław, Poland.
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48
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Masika GM, Yu DSF, Li PWC. Can Visual Art Therapy Be Implemented With Illiterate Older Adults With Mild Cognitive Impairment? A Pilot Mixed-Method Randomized Controlled Trial. J Geriatr Psychiatry Neurol 2021; 34:76-86. [PMID: 32027206 DOI: 10.1177/0891988720901789] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Older adults with mild cognitive impairment (MCI) with no literacy are at increased risk of progression to dementia. Whether it is feasible to engage this population in visual art therapy (VAT) and yield effects on cognition and depression remained unclear. A pilot mixed-method single-blinded randomized controlled trial was conducted in a sample of community-dwelling older adults with MCI. The experimental group (n = 21) was assigned to 12 sessions of VAT over 6 weeks, and the control group (n = 18) was assigned to 6 weekly health education (HE) on nonbrain health topics. Participants were evaluated at baseline using Montreal Cognitive Assessment-5-minute protocol (MoCA-5-min) and Geriatric Depression Scale Short Form (GDS-SF). A focus group discussion (FGD) was also conducted to the experimental group to explore their experiences of participating in the VAT. Findings indicated that both VAT and HE groups had significant improvement in MoCA-5-min scores and depressed mood over time; however, the significant group × time interaction effect was noted only for the psychological outcome. Findings from the FGD indicated that participants had challenging experiences at the beginning of the therapy, but later, they were able to cope and found that the VAT was relevant and beneficial for their cognitive and psychosocial health. This pilot study provided initial evidence about the potential benefit of VAT in improving cognitive and psychological well-being of older adults with MCI and low literacy and provided insights on how to better engage them in this cognitive stimulating intervention. A full-scale trial is recommended for a stringent evaluation.
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Affiliation(s)
- Golden M Masika
- The Nethersole School of Nursing, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong.,Department of Nursing and Midwifery, College of Health Sciences, University of Dodoma, Dodoma, Tanzania
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, 26451The University of Hong Kong, Hong Kong
| | - Polly W C Li
- School of Nursing, Li Ka Shing Faculty of Medicine, 26451The University of Hong Kong, Hong Kong
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49
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Isbel B, Weber J, Lagopoulos J, Stefanidis K, Anderson H, Summers MJ. Neural changes in early visual processing after 6 months of mindfulness training in older adults. Sci Rep 2020; 10:21163. [PMID: 33273707 PMCID: PMC7713117 DOI: 10.1038/s41598-020-78343-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/24/2020] [Indexed: 11/09/2022] Open
Abstract
Mindfulness has been shown to improve attentional performance, which is known to decline in aging. Long-latency electroencephalographic (EEG) event-related potential (ERP) changes have been reported immediately after mindfulness training, however the enduring stability of these effects is unknown. Furthermore, the ability of mindfulness to impact earlier stages of information processing is unclear. We examined neural activation using high density EEG in older adults engaged in mindfulness training to examine the long-term stability of training effects. After 6 months of training, mindfulness practitioners displayed enhanced neural activation during sensory encoding and perceptual processing of a visual cue. Enhanced perceptual processing of a visual cue was associated with increased neural activation during post-perceptual processing of a subsequent target. Similar changes were not observed in a control group engaged in computer-based attention training over the same period. Neural changes following mindfulness training were accompanied by behavioural improvements in attentional performance. Our results are suggestive of increased efficiency of the neural pathways subserving bottom-up visual processing together with an enhanced ability to mobilise top-down attentional processes during perceptual and post-perceptual processing following mindfulness training. These results indicate that mindfulness may enhance neural processes known to deteriorate in normal aging and age-related neurodegenerative diseases.
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Affiliation(s)
- Ben Isbel
- Thompson Institute, University of the Sunshine Coast, Locked Bag 4 (ML59), Maroochydore DC, QLD, 4558, Australia.
| | - Jan Weber
- Graduate Training Center of Neuroscience, International Max Planck Research School, University of Tuebingen, Österbergstrasse 3, 72074, Tuebingen, Germany
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Locked Bag 4 (ML59), Maroochydore DC, QLD, 4558, Australia
| | - Kayla Stefanidis
- Thompson Institute, University of the Sunshine Coast, Locked Bag 4 (ML59), Maroochydore DC, QLD, 4558, Australia
| | - Hannah Anderson
- Thompson Institute, University of the Sunshine Coast, Locked Bag 4 (ML59), Maroochydore DC, QLD, 4558, Australia
| | - Mathew J Summers
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 (ML59), Maroochydore DC, QLD, 4558, Australia
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50
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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.
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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
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