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Zang W, Zou Q, Xiao N, Fang M, Wang S, Chen J. A methodological and reporting quality assessment of systematic reviews/meta-analyses on exercise interventions for cognitive function in older adults with mild cognitive impairment. PeerJ 2024; 12:e17773. [PMID: 39071117 PMCID: PMC11283171 DOI: 10.7717/peerj.17773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
Objective To assess the methodological quality of meta-analytic literature on exercise interventions for cognitive function in patients with mild cognitive impairment (MCI) and the certainty of evidence for its outcome indicators, and to provide clinicians and researchers with more reliable data for making decisions. Methods Meta-analytic literature related to the effect of exercise intervention on cognitive function in patients with mild cognitive impairment was searched through PubMed, Cochrane Library, Embase, Scopus, Physiotherapy Evidence Database and Web of Science, all with a search period frame of each database until June 1, 2024. The AMSTAR2 scale was used to evaluate the methodological quality of the included studies. Results Seventeen meta-analyses were included. The AMSTAR2 scale evaluation results showed that there was one medium-quality studies (5.55%), seven low-quality studies (38.88%), and 10 very low-quality studies (55.55%). Methodological deficiencies included failure to prepare a plan and provide a registration number, literature screening, data extraction, reasons for exclusion not described in detail, poor implementation process for systematic evaluation, and failure to describe the source of funding for the included studies or relevant conflicts of interest. Conclusion The overall methodological quality of the meta-analytic literature is low, and the certainty of evidence is low. We encourage the conduction of high-quality randomized trials to generate stronger evidence. Subsequent systematic reviews can then synthesize this evidence to inform future research and clinical guidelines.
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Affiliation(s)
| | - Qinghai Zou
- Physical Education Department, Harbin Engineering University, Harbin, China
| | - Ningkun Xiao
- Department of Psychology, Ural Federal University, Yekaterinburg, Russia
| | - Mingqing Fang
- Xiangya Hospital, Central South University, Changsha, China
| | - Su Wang
- Harbin Sport University, Harbin, China
| | - Jingjing Chen
- School of Basic Medicine, Changchun University of Chinese Medicine, Jilin, China
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Castellote-Caballero Y, Carcelén Fraile MDC, Aibar-Almazán A, Afanador-Restrepo DF, González-Martín AM. Effect of combined physical-cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial. BMC Med 2024; 22:281. [PMID: 38972988 PMCID: PMC11229192 DOI: 10.1186/s12916-024-03469-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/05/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND The increase in population aging highlights the growing prevalence of mild cognitive impairment, prompting the adoption of interventions that combine physical exercise and cognitive training to improve health and cognitive performance in older adults. The aim of this study was to analyze the efficacy of a combined program on physical and cognitive health in older people with cognitive impairment. METHODS A 12-week randomized controlled clinical trial involving 95 participants (aged 72.12 ± 4.25 years), 47 individuals participated in a control group (CG) that only underwent cognitive stimulation, while 48 individuals were in an experimental group (EG) that participated in a combined program. Balance was measured using the Tinetti scale, upper body strength was assessed with the arm curl test, lower body strength was evaluated with the 30-s chair stand test, flexibility was tested using the back scratch test and chair sit-and-reach test, physical function was measured with the Timed Up and Go test, cognitive function was assessed using the Mini Mental State Examination, cognitive impairment was evaluated with the Montreal Cognitive Assessment, verbal fluency was tested with the Isaac test, and executive functions were assessed using the Trail Making Test. RESULTS The results of the study show significant improvements in both physical and cognitive aspects, such as balance, gait, upper and lower body strength, flexibility, physical function, cognitive function, cognitive impairment, verbal fluency, and executive functions in the group that carried out the intervention compared to the control group. CONCLUSION A combined program for older individuals with mild cognitive impairment leads to enhancements in physical and cognitive health. These improvements underscore the importance of integrating physical exercise with cognitive training as an effective strategy for enhancing overall health and quality of life in older adults. TRIAL REGISTRATION NCT05503641.
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Affiliation(s)
- Yolanda Castellote-Caballero
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | - María Del Carmen Carcelén Fraile
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain.
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | | | - Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
- Department of Psychology, Centro de Educación Superior de Enseñanza e Investigación Educativa, Plaza de San Martín, 4, Madrid, 28013, Spain
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Kalenzaga S, Clarys D. [Les effets de la méditation de pleine conscience sur les symptômes cognitivo- émotionnels dans le trouble cognitif léger et la maladie d'Alzheimer : une revue de littérature narrative]. Can J Aging 2024; 43:217-229. [PMID: 38130165 DOI: 10.1017/s0714980823000612] [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: 12/23/2023] Open
Abstract
La maladie d'Alzheimer se manifeste par des troubles de la mémoire et un déclin cognitif plus général, le plus souvent associés à des troubles de l'humeur et du comportement. Les traitements médicamenteux ayant une efficacité assez modeste, il apparaît nécessaire de leur associer une prise en charge non pharmacologique. La méditation de pleine conscience, qui a des effets bénéfiques sur le fonctionnement cognitif et sur l'état émotionnel, semble être une piste intéressante. Cette revue de littérature narrative se propose de recenser les études ayant testé l'efficacité d'une intervention basée sur la pleine conscience auprès de personnes souffrant de la maladie d'Alzheimer ou à risque de développer cette maladie. Il apparaît que ces interventions présentent un intérêt pour réduire les symptômes cognitifs (troubles attentionnels et mnésiques notamment) et émotionnels (affects dépressifs et anxiété en particulier). Cependant, elles nécessitent un certain nombre de modifications pour être adaptées à ce public.
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Affiliation(s)
- Sandrine Kalenzaga
- UMR-CNRS 7295 Centre de Recherches sur la Cognition et l'Apprentissage, Université de Poitiers, 5, rue Théodore Lefebvre, 86000 Poitiers, France
| | - David Clarys
- UMR-CNRS 7295 Centre de Recherches sur la Cognition et l'Apprentissage, Université de Tours, 3 rue des Tanneurs, B.P. 4103, 37041 Tours Cedex 1
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Jesus AG, Lima MPD, Vilar M, Pachana NA. HEPPI: a randomized controlled trial of the efficacy of a cognitive-emotional intervention for homebound older adults. Aging Ment Health 2024; 28:491-501. [PMID: 37747057 DOI: 10.1080/13607863.2023.2260760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. METHODS Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. RESULTS Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. CONCLUSIONS This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
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Shamir D, Loubani K, Schaham NG, Buckman Z, Rand D. Experiences of Older Adults with Mild Cognitive Impairment from Cognitive Self-Training Using Touchscreen Tablets. Games Health J 2024; 13:13-24. [PMID: 37768834 DOI: 10.1089/g4h.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Background: "Tablet Enhancement of Cognition and Health" (TECH) is a cognitive intervention that includes two components: 5 weeks of daily self-training using puzzle-game apps on a touch screen tablet and weekly group sessions. This study aimed to (i) explore experiences of older adults with mild cognitive impairment (MCI) following their participation in TECH, (ii) identify hindering and enabling factors to self-training, and (iii) describe participants' perceived and objective cognitive changes and examine factors associated with their satisfaction from TECH. Materials and Methods: We used quantitative and qualitative measures; a phenomenological qualitative design using focus groups and interviews of 14 older adults with MCI and a focus group of the TECH facilitators. Satisfaction with TECH, self-training time, and perceived and objective cognitive changes (using the Montreal Cognitive Assessment) were evaluated. Results: Qualitative data were classified into three categories: Memory problems, Hindering and enabling factors to self-training, and Meaningful group sessions. The TECH facilitators reported positive changes, less cognitive complaints, and commitment and satisfaction of the participants. Participants reported overall satisfaction from TECH and performed a median interquartile range of 22.6 (19.9-42.8) self-training hours. Higher satisfaction was correlated with a higher objective cognitive change (r = 0.95, P < 0.01) and less training time (r = -0.91, P < 0.01). Discussion and Conclusions: Participants in the current study actively engaged in daily self-training using touch screen-tablet-puzzle-game and functional apps, driven by both internal and external motivators. Despite the lack of cognitive improvement, they expressed satisfaction with their participation in TECH. Therefore, encouraging older adults to engage in meaningful cognitive stimulating activities is recommended.
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Affiliation(s)
- Dafna Shamir
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Khawla Loubani
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Givon Schaham
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Buckman
- Maccabi-Healthcare Services, Rishon L'Zion, Israel
| | - Debbie Rand
- Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Givon Schaham N, Buckman Z, Rand D. TECH preserves global cognition of older adults with MCI compared with a control group: a randomized controlled trial. Aging Clin Exp Res 2024; 36:1. [PMID: 38252189 PMCID: PMC10803538 DOI: 10.1007/s40520-023-02659-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/09/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Cognitive training using touchscreen tablet casual game applications (apps) has potential to be an effective treatment method for people with mild cognitive impairment (MCI). AIMS This study aimed to establish the effectiveness of 'Tablet Enhancement of Cognition and Health' (TECH), a novel cognitive intervention for improving/preserving cognition in older adults with MCI. METHODS A single-blind randomized controlled trial with assessments pre-, post-, and at 6-month follow-up was conducted. TECH entailed 5 weeks of daily self-training utilizing tablet apps, facilitated by weekly group sessions. Global cognition was assessed by the Montreal Cognitive Assessment (MoCA), and specific cognitive components were assessed using WebNeuro computerized battery. Short Form Health Survey (SF-12) assessed health-related quality of life (HRQoL). Intention-to-treat analysis was conducted and the %change was calculated between pre-post and between pre-follow-up. Cohen's d effect size was also calculated. RESULTS Sixty-one participants aged 65-89 years were randomly allocated to TECH (N = 31, 14 women) or to standard care (N = 30, 14 women). Pre-post and pre-follow-up MoCA %change scores were significantly higher in TECH than control (U = 329.5, p < .05; U = 294.5, p < .05) with intermediate effect size values (Cohen's d = .52, Cohen's d = .66). Forty percent of TECH participants versus 6.5% of control participants achieved a minimal clinical important difference in MoCA. Pre-post between-group differences for specific cognitive components were not found and HRQoL did not change. DISCUSSION AND CONCLUSIONS TECH encouraged daily self-training and showed to preserve global cognition of older adults with MCI. The implementation of TECH is recommended for older adults with MCI, who are at risk for further cognitive decline.
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Affiliation(s)
- Noa Givon Schaham
- Department of Occupational Therapy, Faculty of Medicine, Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Buckman
- Maccabi Healthcare Services, Tel Aviv-Yafo, Israel
| | - Debbie Rand
- Department of Occupational Therapy, Faculty of Medicine, Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel.
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Fan M, Li Q, Yang T, Yang Y, Chen Z, Xuan G, Ruan Y, Sun S, Wang M, Chen X, Huang Y, Yang Z, Wang Y. Effect of Multimodal Intervention in Individuals with Mild Cognitive Impairment: A Randomized Clinical Trial in Shanghai. J Alzheimers Dis 2024; 101:235-248. [PMID: 39031354 PMCID: PMC11380217 DOI: 10.3233/jad-231370] [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: 07/22/2024]
Abstract
Background Previous trials have indicated that multimodal training could improve cognitive functions and moods in individuals with mild cognitive impairment (MCI). However, evidence was mainly obtained from studies in high-income countries. Objective This trial aims to investigate the efficacy, safety, and potential mechanism of a multimodal intervention on cognitive function in individuals with MCI living in a community. Methods In this single-blind, randomized controlled trial, 120 participants with MCI were randomly assigned to either the intervention group or the control group. The intervention group received the multimodal intervention, while the control group received regular health education. Neuropsychological tests and magnetic resonance imaging (MRI) were conducted at baseline and after the 12-week intervention. Results Fifty-nine and fifty-seven participants respectively in the intervention and control groups completed the trial. The intervention group shown improvements in primary outcome, Mini-Mental State Exam (MMSE) total score (mean difference -0.96, 95% CI [-1.58, -0.34], p = 0.003), and secondary outcomes: MMSE recall (-0.39, 95% CI [-0.71, -0.07], p = 0.019), MMSE language (-0.26, 95% CI [-0.44, -0.07], p = 0.007), Auditory Verbal Learning Test instantaneous memory (-3.30, 95% CI [-5.70, -0.89], p = 0.008), Digit Symbol Substitution Test total score (-2.91, 95% CI [-5.67, -0.15], p = 0.039), digit span forwards (-1.25, 95% CI [-1.93, -0.56], p < 0.001), and Digit Span Test (-1.33, 95% CI [-2.33, -0.34], p = 0.009) compared to the control group. Improvements were observed in structural and functional connectivity related to language, concentration, executive function, memory, and recall functioning via MRI in the intervention group. Conclusions The multimodal intervention improved cognitive function in individuals with MCI in cognitive performance and neuroimaging.
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Affiliation(s)
- Meixiang Fan
- Department of General Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qingfeng Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Tingting Yang
- Shanghai Center for Clinical Laboratory, Shanghai, China
| | - Yinghua Yang
- Shanghai Center for Clinical Laboratory, Shanghai, China
| | - Zhihua Chen
- Medicine-Mental Health Center of Minhang District, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Guo Xuan
- Medicine-Mental Health Center of Minhang District, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Ye Ruan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shuangyuan Sun
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Meng Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Xiaoli Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Yanyan Huang
- Department of General Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Tianqiao and Chrissy Chen Institute Clinic Translational Research Center, Shanghai, China
- Department of Geriatrics, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhi Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Institute of Psychological and Behavioural Science, Shanghai Jiao Tong University, Shanghai, China
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, China
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8
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Kostyuk GP, Tkhostov AS, Skvortsov AA, Kovyazina MS, Kurmyshev MV, Gusev AN, Andryushenko AV, Varako NA, Savilov VB, Kremlev AE, Osipova NG. [Dynamics of cognitive functions using the rehabilitation program of cognitive training]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:102-112. [PMID: 38884436 DOI: 10.17116/jnevro2024124051102] [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: 06/18/2024]
Abstract
OBJECTIVE To study the efficiency of the neuropsychological rehabilitation of patients with mild cognitive impairments. MATERIAL AND METHODS The study included 103 elderly people, aged 59 to 88 years, including 90 women and 13 men with subjective complaints of memory loss (ICD-10: F06.70; F06.71; F06.78; F06.79). Participants were divided into experimental group (n=43) and comparison group (n=42). The estimated impact was the rehabilitation program «The psychosocial therapy and neurocognitive rehabilitation of elderly patients with cognitive impairments», within which the principle of complex stimulation of various parameters of the cognitive sphere was used in rehabilitation work with patients in the experimental group in accordance with the «Memory Clinic» program. The study was conducted using randomized, equalized comparison groups, and the principle of «triple-blind» research. Non-parametric statistics (SPSS) methods were used to assess differences. RESULTS A significant difference between the comparison and experimental groups has been identified, primarily in relation to high-level mental processes associated with the function of the third structural-functional block according to A.R. Luria. After the training, the number of correct answers significantly increased (t(42)=-2.67, p<0.001) in the experimental group, while in the comparison group the indicator did not change (t(41)=0.50, p=0.617). The number of false alarms in the experimental group decreased significantly (t(42)=2.13, p=0.039). CONCLUSION The results confirm the leading role of these processes in the hierarchy of mental functions, which suggests that they should primarily be targets of rehabilitation interventions.
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Affiliation(s)
- G P Kostyuk
- Lomonosov Moscow State University, Moscow, Russia
- Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow, Moscow, Russia
| | - A Sh Tkhostov
- Lomonosov Moscow State University, Moscow, Russia
- Psychological Institute of the Russian Academy of Education, Moscow, Russia
| | - A A Skvortsov
- National Research University Higher School of Economics, Moscow, Russia
| | - M S Kovyazina
- Lomonosov Moscow State University, Moscow, Russia
- Psychological Institute of the Russian Academy of Education, Moscow, Russia
- Scientific Center of Neurology, Institute of Neurorehabilitation and Restorative Technologies, Moscow, Russia
| | - M V Kurmyshev
- Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow, Moscow, Russia
| | - A N Gusev
- Lomonosov Moscow State University, Moscow, Russia
| | - A V Andryushenko
- Lomonosov Moscow State University, Moscow, Russia
- Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow, Moscow, Russia
| | - N A Varako
- Lomonosov Moscow State University, Moscow, Russia
- Psychological Institute of the Russian Academy of Education, Moscow, Russia
- Scientific Center of Neurology, Institute of Neurorehabilitation and Restorative Technologies, Moscow, Russia
| | - V B Savilov
- Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow, Moscow, Russia
| | - A E Kremlev
- Lomonosov Moscow State University, Moscow, Russia
| | - N G Osipova
- Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow, Moscow, Russia
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de Oliveira TR, Manzine PR, Cominetti MR, Leite OD, Faria RC. Electrochemical magneto-immunoassay for detection of ADAM10 Alzheimer's biomarker using gold nanoparticles as label. Talanta 2024; 266:125042. [PMID: 37591151 DOI: 10.1016/j.talanta.2023.125042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023]
Abstract
Alzheimer's disease (AD), a neurodegenerative and progressive illness with no known cure, is the most frequent cause of dementia in older adults. Dementia in AD is usually preceded by a stage of cognitive decline known as mild cognitive impairment (MCI). MCI has gained attention as an ideal target for prevention and early interventions, considering its reversible characteristic. Here, we propose a magneto-immunoassay based on a low-cost screen-printed electrode for detecting soluble ADAM10 in plasma samples, a potential biomarker for early AD diagnosis. We present a sandwich immunoassay using magnetic beads modified with antibodies to capture ADAM10 from plasma samples and using gold nanoparticles (AuNPs) as an electrochemical label. The assay was designed to accurately detect ADAM10 in diluted plasma with a limit of detection (LoD) of 32.5 pg/mL and a dynamic linear range of 10.0-1000.0 pg/mL. Twenty-three plasma samples from the elderly, including patients with AD, MCI, and healthy subjects (negative control), were analyzed by the magneto-immunoassay and enzyme-linked immunosorbent assay (ELISA), and the ADAM10 levels correlated. This work shows the potential of this protein as a biomarker in the early diagnosis and progression of AD and provides an interesting disposable device with capabilities for applications as point-of-care (PoC) to measure ADAM10 levels.
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Affiliation(s)
- Tássia R de Oliveira
- Department of Chemistry, Federal University of São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Patricia R Manzine
- Department of Gerontology, Federal University of São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Márcia R Cominetti
- Department of Gerontology, Federal University of São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Oldair D Leite
- Department of Chemistry, Federal Technological University of Paraná, Medianeira, PR, 85884-000, Brazil
| | - Ronaldo C Faria
- Department of Chemistry, Federal University of São Carlos, São Carlos, SP, 13565-905, Brazil.
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10
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Lissek VJ, Orth S, Suchan B. go4cognition: Evaluation of a Newly Developed Multicomponent Intervention in Mild Cognitive Impairment. J Alzheimers Dis 2024; 99:377-392. [PMID: 38669526 DOI: 10.3233/jad-230802] [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: 04/28/2024]
Abstract
Background Cognitive training and physical exercise show positive effects on cognitive decline in subjects with mild cognitive impairment (MCI). Multimodal interventions for MCI patients, combining physical and cognitive training in a social context seem to slow down cognitive decline. Objective Based on a previous study, a new mobile gamification tool (go4cognition; https://www.ontaris.de/go4cognition) has been developed to train cognitive and physical functions simultaneously in a group setting. It involves tasks targeting various cognitive functions (short-term memory, working memory, executive functions). The computer-based setup allows for individual performance analysis. This study evaluated the effects of this tool. Methods 30 participants with MCI, as defined by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) cut-off-score, aged between 66 and 89 years, trained for one hour two days a week for twelve weeks. Additionally, standard neuropsychological assessment of memory and attention was carried out before and after the intervention. Results The go4cognition device is highly effective in improving various cognitive functions. A significant improvement in the CERAD total score resulting in re-classification of 70% of former MCI patients into non-MCI patients was found. Additionally, an improvement of verbal fluency, verbal memory, spatial memory, and attention was observed. Furthermore, the CERAD total score was significantly correlated with performance in the go4cognition tool. Conclusions The results of the intervention support the idea of the effectiveness of a combined cognitive and motor intervention by incorporating neuropsychological paradigms in a group setting and suggest a close relation between combined cognitive and physical exercise and cognitive performance.
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Affiliation(s)
- Vanessa J Lissek
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| | | | - Boris Suchan
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
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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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Raimo S, Cropano M, Gaita M, Maggi G, Cavallo ND, Roldan-Tapia MD, Santangelo G. The Efficacy of Cognitive Training on Neuropsychological Outcomes in Mild Cognitive Impairment: A Meta-Analysis. Brain Sci 2023; 13:1510. [PMID: 38002471 PMCID: PMC10669748 DOI: 10.3390/brainsci13111510] [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: 09/11/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Mild cognitive impairment (MCI) or mild neurocognitive disorder is an intermediate stage of cognitive impairment between normal cognitive aging and dementia. Given the absence of effective pharmacological treatments for MCI, increasing numbers of studies are attempting to understand how cognitive training (CT) could benefit MCI. This meta-analysis aims to update and assess the efficacy of CT on specific neuropsychological test performance (global cognitive functioning, short-term verbal memory, long-term verbal memory, generativity, working memory, and visuospatial abilities) in individuals diagnosed with MCI, as compared to MCI control groups. After searching electronic databases for randomized controlled trials, 31 studies were found including 2496 participants. Results showed that CT significantly improved global cognitive functioning, short-term and long-term verbal memory, generativity, working memory, and visuospatial abilities. However, no significant effects were observed for shifting, abstraction ability/concept formation, processing speed, and language. The mode of CT had a moderating effect on abstraction ability/concept formation. The findings provide specific insights into the cognitive functions influenced by CT and guide the development of tailored interventions for MCI. While CT holds promise, further research is needed to address certain cognitive deficits and assess long-term effects on dementia progression.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Maria Cropano
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Mariachiara Gaita
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Gianpaolo Maggi
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Nicola Davide Cavallo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | | | - Gabriella Santangelo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
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Park JY, Choi SA, Kim JJ, Park YJ, Kim CK, Cho GJ, Koh SB, Kang SH. Effect of Tablet-based Cognitive Intervention on Cognition in Patients With Mild Cognitive Impairment: A Pilot Study. Dement Neurocogn Disord 2023; 22:130-138. [PMID: 38025410 PMCID: PMC10654482 DOI: 10.12779/dnd.2023.22.4.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Purpose Growing evidence has shown that cognitive interventions can mitigate cognitive decline in patients with mild cognitive impairment (MCI). However, most previous cognitive interventions have been group-based programs. Due to their intrinsic limitations, group-based programs are not widely used in clinical practice. Therefore, we have developed a tablet-based cognitive intervention program. This preliminary study investigated the feasibility and effects of a 12-week structured tablet-based program on cognitive function in patients with MCI. Methods We performed a single-arm study on 24 patients with MCI. The participants underwent a tablet-based cognitive intervention program 5 times a week over a 12-week period. The primary outcome was changes in cognitive function, measured using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Outcomes were evaluated at baseline, within two weeks of the last program (post-intervention), and at the six-month follow-up session. Results The completion rate of the tablet-based program was 83.3% in patients with MCI. The program improved cognitive function based on the CERAD-K total score (p=0.026), which was maintained for at least three months (p=0.004). There was also an improvement in the depression scale score (p=0.002), which persisted for three months (p=0.027). Conclusions Our 12-week structured tablet-based program is feasible for patients with MCI. Furthermore, although further studies with a double-arm design are required, the program appears to be an effective strategy to prevent cognitive decline in patients with MCI.
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Affiliation(s)
| | | | | | - Yu Jeong Park
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Hoon Kang
- Geumcheon Center for Dementia, Seoul, Korea
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Yeh TT, Chang KC, Wang JJ, Lin WC, Wu CY. Neuroplastic Changes Associated With Hybrid Exercise-Cognitive Training in Stroke Survivors With Mild Cognitive Decline: A Randomized Controlled Trial. Neurorehabil Neural Repair 2023; 37:662-673. [PMID: 37750660 DOI: 10.1177/15459683231200220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
BACKGROUND Exercise and cognitive training have been shown to induce neuroplastic changes and modulate cognitive function following stroke. However, it remains unclear whether hybridized exercise-cognitive training facilitates cortical activity and further influences cognitive function after stroke. OBJECTIVE The study aimed to investigate the effects of 2 hybridized exercise-cognitive trainings on neuroplastic changes and behavioral outcomes in stroke survivors with mild cognitive decline. METHODS This study was a single-blind randomized controlled trial. Stroke survivors were randomly assigned to 1 of 3 groups: (1) sequential exercise-cognitive training (SEQ), (2) dual-task exercise-cognitive training (DUAL), or (3) control group (CON). All groups underwent training 60 min per day, 3 days per week, for a total of 12 weeks. The primary outcome was the resting-state (RS) functional connectivity (FC) in functional magnetic resonance imaging. Secondary behavioral outcomes included cognitive and physical functions. RESULTS After 12 weeks of training, patients in the SEQ group (n = 21) exhibited increased RS FC between the left occipital lobe and posterior cingulate gyrus with right parietal lobe, compared to the DUAL (n = 22) and CON (n = 20) groups. Additionally, patients in the DUAL group showed increased FC of the left temporal lobe. However, changes in behavioral outcome measures were non-significant among the 3 groups (all P's > .05). CONCLUSIONS This study highlights the distinct neuroplastic mechanisms associated with 2 types of exercise-cognitive hybridized trainings. The pre-post functional magnetic resonance imaging measurements illustrated the time course of neural mechanisms for cognitive recovery in stroke survivors following different exercise-cognitive training approaches. Trial registration. NCT03230253.
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Affiliation(s)
- Ting-Ting Yeh
- Master Degree Program in Health and Long-term Care Industry, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ku-Chou Chang
- Division of Cerebrovascular diseases, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
- Long-term care service center, Kaohsiung Chang Gung Memorial Hospital, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taiwan
| | - Jiun-Jie Wang
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Radiology, Jen Ai Chang Gung Health, Taichung, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ching-Yi Wu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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Ross SD, Rodriguez FS. Usability of a memory aid handbook for older people with subjective cognitive impairment-An explorative pilot study. Int J Geriatr Psychiatry 2023; 38:e5989. [PMID: 37594395 DOI: 10.1002/gps.5989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/12/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Memory problems are common in advanced age. Memory strategies can be used to manage such challenges. To assist older people facing memory problems, we conducted a pilot study to evaluate the usability of a memory aid handbook that we developed specifically for this purpose. METHOD A memory aid handbook with a 7-week program was developed based on a systematic review. A total of 19 older people with self-reported memory problems (mean age: 76.11 years, female: 73.68%) tested the memory aid handbook and completed the System Usability Scale (SUS), a checklist on the relevance of the strategies in the handbook, and questionnaires on daily life functioning and self-efficacy. Further, they participated in cognitive tests. In a pre-post design, within-subject differences were determined using paired t-tests. RESULTS The usability of the memory aid handbook scores as were high (mean SUS score: 99.21). The checklist indicated that the handbook was perceived as beneficial for confirming already established memory strategies and stimulating new ones, such as self-acceptance, visualizing and verbalizing daily routines, and asking for help. In addition, the checklist revealed that using a calendar was considered the most helpful strategies for daily living, followed closely by taking notes, having specific places for certain items and creating routines in daily life. After the 7 weeks, participants scored significantly better in the cognitive and self-efficacy tests. The exploratory nature of the study combined with the small sample size should be considered when interpreting the results. CONCLUSION The usability of the handbook was high, reflecting the relevance of the strategies it contains. Teaching memory strategies can be a useful, inexpensive method to foster independence among those at risk for cognitive impairment.
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Affiliation(s)
- Sabrina D Ross
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology & Public Health, Greifswald, Germany
| | - Francisca S Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology & Public Health, Greifswald, Germany
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Shi X, Wang Y, Wu Y, Li J. The effect of the leisure activities based on chess and cards for improving cognition of older adults: study protocol for a cluster randomized controlled trial. Trials 2023; 24:484. [PMID: 37516846 PMCID: PMC10386780 DOI: 10.1186/s13063-023-07528-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND With the increase in age, the probability of cognitive impairment in the older people is increasing. More and more evidence shows that participating in leisure activities, especially chess and cards, is beneficial to the cognition and mental state of the older people. But the evidence for causal inference is limited. There is a need to conduct a fully powered randomized controlled trial (RCT) and long-term follow-up to test the effectiveness of intervention measures in improving cognitive function and mental state. This paper describes the methodology of a cluster RCT designed to determine the effect of chess and cards leisure activities on the cognitive function of the older people over 60 years old. METHODS/DESIGN A cluster RCT consisting of 8 clusters will be conducted in four regions of Ningxia, China (Helan, Litong, Qingtongxia, and Shapotou). Clusters will be randomly assigned to the advocacy intervention group, which is also delivered with free leisure activities tools (chess and cards), or the control group. A baseline survey will be conducted before the intervention. A mid-term and final survey will be carried out twelve and twenty-four months after the intervention, respectively. The primary outcome is a change in cognitive function, and the secondary outcomes are changes in anxiety, depression, and loneliness. DISCUSSION The results of this RCT will be helpful to (1) confirm the effectiveness of chess and cards leisure activities in improving the cognitive function of the older people over 60 years old; (2) determine the relationship between the frequency and duration of chess and cards leisure activities and cognitive function; (3) provide evidence of promoting participation in leisure activities through education campaigns and free provision of chess and cards tools; and (4) provide valuable information for successful aging. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2200066817. Registered on 19 December 2022.
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Affiliation(s)
- Xiaojuan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yanrong Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yueping Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China.
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Hui Autonomous Region, Yinchuan, 750004, Ningxia, China.
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Jung YH, Park SC, Lee JH, Kim MJ, Lee S, Chung SJ, Moon JY, Choi YH, Ju J, Han HJ, Lee SY. Effect of internet-based vs. in-person multimodal interventions on patients with mild to moderate Alzheimer's disease: a randomized, cross-over, open-label trial. Front Public Health 2023; 11:1203201. [PMID: 37483927 PMCID: PMC10361252 DOI: 10.3389/fpubh.2023.1203201] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Objective We aimed to investigate the effect of internet-based and in-person cognitive interventions on cognition, mood, and activities of daily living (ADL) on patients with mild to moderate Alzheimer's disease (AD) and examine whether internet-based intervention is as effective as the in-person intervention. Methods We recruited 52 patients with probable mild AD, of whom 42 completed the trial. We randomly divided participants into intervention and control groups at a 1:1 ratio and statistically compared the neuropsychological test results of the two groups. In addition, patients in the intervention group were randomly assigned to a 4 weeks internet-based or in-person intervention, with subsequent crossover to the other group for 4 weeks. We statistically analyzed and compared the neuropsychological test scores between internet-based and in-person interventions. Results Compared with the control group, the intervention group (internet-based and in-person) showed significantly improved profile in cognition (p < 0.001), depression (p < 0.001), anxiety (p < 0.001) and ADL (p < 0.001). In addition, the effect of the internet-based intervention on cognition (p = 0.918) and depression (p = 0.282) was not significantly different from that of the in-person intervention. However, in the Beck anxiety inventory (p = 0.009) and Seoul instrumental activity of daily living (p = 0.023), in-person intervention was more effective than internet-based intervention. Conclusion This study suggests that both types of cognitive intervention (in-person and internet-based) may be viable supplementary treatments along with approved pharmacological therapy. In terms of anxiety and ADL, the effect of the in-person interventions may be more effective than the-internet based interventions.
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Affiliation(s)
- Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Sang-Cheol Park
- Artificial Intelligence and Robotics Laboratory, Myongji Hospital, Goyang, Republic of Korea
| | - Jee Hee Lee
- Department of Public Health and Healthcare Service, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Myong Jong Kim
- Center for Arts and Healing, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Seunghoon Lee
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Su Jin Chung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Ji Yeon Moon
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Young Hi Choi
- Cheongpungho Geriatric Hospital, Jecheon, Republic of Korea
| | - Jieun Ju
- Center for Arts and Healing, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - So Young Lee
- Center for Arts and Healing, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
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Tulliani N, Bye R, Bissett M, Coutts S, Liu KPY. The feasibility and acceptability of an app-based cognitive strategy training programme for older people. Pilot Feasibility Stud 2023; 9:109. [PMID: 37391842 DOI: 10.1186/s40814-023-01334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/07/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Increasing numbers of people are living with mild cognitive impairment in later life and seeking therapy to maintain cognition to remain as independent as possible in daily life. Based on a review of the literature, an app-based programme using perceptual-encoding strategies called Enhancing Memory in Daily Life (E-MinD Life) was developed. An expert panel reviewed the programme's appropriateness for older people with and without mild cognitive impairment. As part of the design process, the feasibility and acceptability of the E-MinD Life programme were then assessed in relation to its use by healthy older adults, with findings informing the application of the programme to older people with mild cognitive impairment in the future. METHODS Phase 1: The E-MinD Life programme was reviewed by an expert panel of occupational therapists. Experts rated the programme on a Likert scale and answered open-ended questions in relation to feasibility, clarity, and relevancy. Phase 2 involved field-testing the 9-week programme with a sample of nine healthy older people. Participants rated the acceptability of the programme on a Likert scale questionnaire. Data on recruitment rates and retention, and adherence and duration of sessions were collected to determine the feasibility of the programme. Responses to the Likert scale were analysed using descriptive statistics. Open-ended responses were categorised qualitatively using a constant comparative approach. RESULTS Phase 1: Experts indicated that the E-MinD Life programme was feasible and included relevant activities for community living. Although experts felt that an older user with mild NCD would be able to independently complete the programme, the qualitative analysis suggests formatting changes in future iterations of the programme to enhance visual clarity. Phase 2: All participants completed the 9-week programme. The average number of self-administered sessions attempted over the 9-week period was 13.44 (SD = 6.73) out of 18 scheduled sessions. Overall, most participants found the programme relevant, logical and easy to understand, and perceived it to be effective for functional cognitive problems. CONCLUSION The E-MinD Life programme shows promise for inclusion into trial designs to determine the effectiveness of the cognitive strategy programme for older people with and without cognitive impairment. TRIAL REGISTRATION ClinicalTrials.gov, NCT03430401. Registered 1 February 2018.
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Affiliation(s)
- Nikki Tulliani
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia.
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
| | - Michelle Bissett
- Faculty of Health, Southern Cross University, QLD, Gold Coast, Australia
| | - Samantha Coutts
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
- Translation Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Perra A, Riccardo CL, De Lorenzo V, De Marco E, Di Natale L, Kurotschka PK, Preti A, Carta MG. Fully Immersive Virtual Reality-Based Cognitive Remediation for Adults with Psychosocial Disabilities: A Systematic Scoping Review of Methods Intervention Gaps and Meta-Analysis of Published Effectiveness Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1527. [PMID: 36674283 PMCID: PMC9864668 DOI: 10.3390/ijerph20021527] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cognitive Remediation (CR) programs are effective for the treatment of mental diseases; in recent years, Virtual Reality (VR) rehabilitation tools are increasingly used. This study aimed to systematically review and meta-analyze the published randomized controlled trials that used fully immersive VR tools for CR programs in psychiatric rehabilitation. We also wanted to map currently published CR/VR interventions, their methods components, and their evidence base, including the framework of the development intervention of CR in fully immersive VR. METHODS Level 1 of evidence. This study followed the PRISMA extension for Scoping Reviews and Systematic Review. Three electronic databases (Pubmed, Cochrane Library, Embase) were systematically searched, and studies were included if they met the eligibility criteria: only randomized clinical trials, only studies with fully immersive VR, and only CR for the adult population with mental disorders. RESULTS We found 4905 (database) plus 7 (manual/citation searching articles) eligible studies. According to inclusion criteria, 11 studies were finally reviewed. Of these, nine included patients with mild cognitive impairment, one with schizophrenia, and one with mild dementia. Most studies used an ecological scenario, with improvement across all cognitive domains. Although eight studies showed significant efficacy of CR/VR, the interventions' development was poorly described, and few details were given on the interventions' components. CONCLUSIONS Although CR/VR seems to be effective in clinical and feasibility outcomes, the interventions and their components are not clearly described. This limits the understanding of the effectiveness and undermines their real-world implementation and the establishment of a gold standard for fully immersive VR/CR.
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Affiliation(s)
- Alessandra Perra
- International PhD in Innovation Sciences and Technologies, Department of Mechanical Chemistry and Materials Engineering, University of Cagliari, 09042 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Chiara Laura Riccardo
- Department of Clinical and Biological Sciences, University of Turin, 10126 Turin, Italy
| | | | - Erika De Marco
- Azienda Sociosanitaria Ligure 2, Dipartimento di Salute Mentale e delle Dipendenze, 17100 Savona, Italy
| | | | | | - Antonio Preti
- Department of Neuroscience, University of Turin, 10126 Turin, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
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Mraz H, Tong CY, Liu KPY. Semantic-based memory-encoding strategy and cognitive stimulation in enhancing cognitive function and daily task performance for older adults with mild cognitive impairment: A pilot non-randomised cluster controlled trial. PLoS One 2023; 18:e0283449. [PMID: 36972279 PMCID: PMC10042350 DOI: 10.1371/journal.pone.0283449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
AIM To investigate the effectiveness of a semantic-based memory-encoding strategy intervention and cognitive stimulation that enhances function for older adults with mild cognitive impairment. METHODS A two-armed single-blind non-randomised cluster controlled trial was conducted. Participants in two centres were allocated to the semantic-based memory-encoding experimental group and those in the other two centres received cognitive stimulation. In both groups, one centre- or community-based session and one home-based session were provided weekly for 10 weeks. Outcome measures included attention, memory and general cognitive function (Word List Memory and Word List Recall of the Consortium to Establish a Registry for the Alzheimer's disease, Digit Span Forwards and Backwards and the Cognistat), and daily task performance (Disability Assessment for Dementia and Lawton Instrumental Activities of Daily Living Scale). They were administered pre- and post-intervention. RESULTS Thirty-nine participants completed the study. No significant differences were revealed in the demographic or baseline data. The experimental group showed significant improvements in daily task performance (Disability Assessment for Dementia; p = 0.003), memory outcomes (Word List Recall; p < 0.001), general cognitive function (Cognistat subtests of Memory and Similarity; ps = 0.002 and < 0.001). The cognitive stimulation control group did not show any significant improvement in the measures. Between-group analysis showed significant differences in favour of the experimental group for the outcome measures of the Word List Recall and Cognistat Similarity subtest (ps < 0.001). CONCLUSIONS This study shows that the semantic-based memory-encoding strategy is more superior than cognitive stimulation with improvements in attention, memory, general cognitive function and daily task performance for people with a mild cognitive impairment. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration and Results System (NCT02953964).
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Affiliation(s)
- Hannah Mraz
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | | | - Karen P. Y. Liu
- School of Health Sciences, Western Sydney University, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- * E-mail:
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Tulliani N, Bissett M, Fahey P, Bye R, Liu KPY. Efficacy of cognitive remediation on activities of daily living in individuals with mild cognitive impairment or early-stage dementia: a systematic review and meta-analysis. Syst Rev 2022; 11:156. [PMID: 35918712 PMCID: PMC9344685 DOI: 10.1186/s13643-022-02032-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/17/2022] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Instrumental activities of daily living are essential for ageing well and independent living. Little is known about the effectiveness of cognitive remediation on instrumental activities of daily living performance for individuals with mild cognitive impairment or early-stage dementia. The objective of this study was to evaluate the immediate and long-term carryover effects of cognitive remediation on improving or maintaining instrumental activities of daily living performance in older adults with mild cognitive impairment and early-stage dementia. METHODS Randomized controlled trials published from 2009 to 2022 were identified in OvidSP versions of MEDLINE and Embase, EBSCO versions of CINAHL and PsycINFO, and the Cochrane Central Register of Controlled Trials. A narrative synthesis of the findings was reported on the outcomes of the included studies. Relevant data was extracted and analysed using R software's 'metafor' package with a random effect model with 95% CI. RESULTS Thirteen studies, totalling 1414 participants, were identified in the narrative analysis. The results of meta-analysis, inclusive of 11 studies, showed that cognitive remediation elicited a significant improvement in the instrumental activities of daily living performance (SMD: 0.17, 95% CI 0.03-0.31). There was insufficient evidence of any lasting effect. DISCUSSION Cognitive remediation is effective in improving instrumental activities of daily living performance immediately post-intervention in older adults with mild cognitive impairment and early-stage dementia. It appears that individualized interventions with a short duration, such as 10 hours, might be beneficial. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016042364.
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Affiliation(s)
- Nikki Tulliani
- School of Health Sciences, Western Sydney University, Penrith, NSW Australia
| | - Michelle Bissett
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Penrith, NSW Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, Penrith, NSW Australia
| | - Karen P. Y. Liu
- School of Health Sciences, Western Sydney University, Penrith, NSW Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
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Jesus AG, de Lima MP, Vilar M, Pachana NA. Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial. Clin Gerontol 2022; 46:359-375. [PMID: 35916398 DOI: 10.1080/07317115.2022.2105670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology. METHODS Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index). RESULTS The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed. CONCLUSIONS Results provide evidence of the HEPPI's feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. CLINICAL IMPLICATIONS Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Australia
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Lissek VJ, Ben Abdallah H, Praetorius A, Ohmann T, Suchan B. go4cognition: Combined Physiological and Cognitive Intervention in Mild Cognitive Impairment. J Alzheimers Dis 2022; 89:449-462. [DOI: 10.3233/jad-220145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: While cognitive interventions in mild cognitive impairment (MCI) show positive effects on cognitive performance, physical activity appear to slow down cognitive decline, suggesting a relationship between both factors. However, previous combined programs that have shown significant improvement in cognitive function in MCI have typically trained cognition and physical functioning separately. Objective: This project aimed at evaluating two group interventions combining the stimulation of physical and cognitive domains in individuals with MCI: Simultaneous stimulation of physical and cognitive skills in comparison to a standardized training, which stimulates cognitive and physical functions separately. Methods: The study was designed as a randomized controlled trial. The first group was trained on the SpeedCourt® system while the second group completed the standardized Fitfor100 program. Training was completed by a total of 39 subjects with diagnosed MCI as determined by the CERAD (SpeedCourt®: 24 subjects, Fitfor100:15 individuals). Results: There were significant improvements of physical factors (e.g., hand strength and balance) in both groups. Improvement in the CERAD total score allowed for a post interventional classification of all participants into non-MCI and MCI. This effect persisted over a period of three months. Both forms of intervention were found to be effective in improving various cognitive functions which persisted for a period of three months. Conclusion: Both evaluated non-pharmacological, multicomponent interventions, which combined physical and cognitive training in a social setting showed improvement of cognitive functions leading to a persistent classification of former MCI patients in non-MCI patients.
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Affiliation(s)
- Vanessa J. Lissek
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| | | | - Arthur Praetorius
- Department of Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg gGmbH, Duisburg, Germany
| | - Tobias Ohmann
- Research Department, BG Klinikum Duisburg gGmbH, Duisburg, Germany
| | - Boris Suchan
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
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Kognitive Interventionen bei der Alzheimer-Krankheit. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022; 90:344-351. [PMID: 35858612 DOI: 10.1055/a-1869-4377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Cognitive interventions (CI) are an important part in the treatment of Alzheimer's disease (AD). These non-pharamcological treatment options are manifold and can be matched to a patient's particular symptoms and needs. This article gives an overview of CIs and their theoretical background, as well as empirical evidence concerning their efficacy at different stages of the disease. Specific determinants of their effectiveness and possible clinical applications are discussed, while also recent developments, such as computer-based CIs, are considered.
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25
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Mistler CB, Idiong CI, Copenhaver MM. Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder. Front Public Health 2022; 10:825988. [PMID: 35223742 PMCID: PMC8866309 DOI: 10.3389/fpubh.2022.825988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive dysfunction is disproportionately prevalent among persons with opioid use disorder (OUD). Specific domains of cognitive dysfunction (attention, executive functioning, memory, and information processing) may significantly impede treatment outcomes among patients on medication for OUD (MOUD). This limits patient's ability to learn, retain, and apply information conveyed in behavioral intervention sessions. Evidence-based accommodation strategies have been integrated into behavioral interventions for other patient populations with similar cognitive profiles as persons with OUD; however, the feasibility and efficacy of these strategies have not yet been tested among patients on MOUD in a drug treatment setting. METHODS We conducted a series of focus groups with 25 key informants (10 drug treatment providers and 15 patients on MOUD) in a drug treatment program in New Haven, CT. Using an inductive approach, we examined how cognitive dysfunction impedes participant's ability to retain, recall, and utilize HIV prevention information in the context of drug treatment. RESULTS Two main themes capture the overall responses of the key informants: (1) cognitive dysfunction issues and (2) accommodation strategy suggestions. Subthemes of accommodation strategies involved suggestions about particular evidence-based strategies that should be integrated into behavioral interventions for persons on MOUD. Specific accommodation strategies included: use of a written agenda, mindfulness meditation, multi-modal presentation of information, hands-on demonstrations, and a formal closure/summary of sessions. CONCLUSIONS Accommodation strategies to compensate for cognitive dysfunction were endorsed by both treatment providers and patients on MOUD. These accommodation strategies have the potential to enhance the efficacy of behavioral interventions to reduce HIV transmission among persons on MOUD as well as addiction severity, and overdose.
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Affiliation(s)
- Colleen B. Mistler
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
| | - Christie I. Idiong
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
| | - Michael M. Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
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The effect of combined cognitive intervention and physical exercise on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials. Aging Clin Exp Res 2022; 34:261-276. [PMID: 34383248 DOI: 10.1007/s40520-021-01877-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/03/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The state of mild cognitive impairment (MCI) provides an optimal window for preventing progression to dementia. Combined cognitive intervention and physical exercise may yield additive and synergistic effects on cognition in older adults with MCI. OBJECTIVES The purpose of this study was to assess the efficacy of a combined intervention to improve cognition in older adults with MCI by comparing a control group that underwent only cognitive intervention, a control group that underwent only physical exercise, and a control group that did not undergo cognitive intervention or physical exercise. DESIGN Meta-analysis of randomized controlled trials (RCTs). DATA SOURCES The online databases of PubMed, Web of Science, Embase, the Cochrane Library, PsycINFO, and CINAHL were systematically searched. REVIEW METHODS The outcomes were global cognition, memory, and executive function/attention. A sensitivity analysis was conducted when the I2 statistic was > 50%. RESULTS A total of 16 studies were included. The results showed that the combined intervention had positive effects on global cognition compared to the effects of the other control group [SMD = 0.27, 95% CI (0.09, 0.44), p = 0.003]. Regarding memory, the combined intervention had positive effects compared to the effects observed in the single physical exercise group [SMD = 0.25, 95% CI (0.07, 0.44), p = 0.006] and the other control group [SMD = 0.29, 95% CI (0.12, 0.47), p = 0.001]. For executive function/attention, the combined intervention had also positive effects compared to the effects of the single cognitive intervention group [SMD = 0.28, 95% CI (0.09, 0.47), p = 0.004], the single physical exercise group [SMD = 0.32, 95% CI (0.16, 0.49), p = 0.0002], and the other control group [SMD = 0.23, 95% CI (0.05, 0.41), p = 0.01]. CONCLUSIONS The combined intervention resulted in cognitive benefits in older adults with MCI and exhibited limited superiority over the single cognitive intervention and the single physical exercise on cognitive subdomains.
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Chen J, Chen R, Xue C, Qi W, Hu G, Xu W, Chen S, Rao J, Zhang F, Zhang X. Hippocampal-Subregion Mechanisms of Repetitive Transcranial Magnetic Stimulation Causally Associated with Amelioration of Episodic Memory in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2021; 85:1329-1342. [PMID: 34924374 DOI: 10.3233/jad-210661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Altered hippocampal subregions (HIPsub) and their network connectivity relate to episodic memory decline in amnestic mild cognitive impairment (aMCI), which is significantly limited by over-dependence on correlational associations. Objective: To identify whether restoration of HIPsub and its network connectivity using repetitive transcranial magnetic stimulation (rTMS) is causally linked to amelioration of episodic memory in aMCI. Methods: In the first cohort, analysis of HIPsub grey matter (GM) and its functional connectivity was performed to identify an episodic memory-related circuit in aMCI by using a pattern classification approach. In the second cohort, this circuit was experimentally modulated with rTMS. Structural equation modeling was employed to investigate rTMS regulatory mechanism in amelioration of episodic memory. Results: First, in the first cohort, this study identified HIPsub circuit pathology of episodic memory decline in aMCI patients. Second, in the second cohort, restoration of HIPc GM and its connectivity with left middle temporal gyrus (MTG.L) are causally associated with amelioration of episodic memory in aMCI after 4 weeks of rTMS. Especially important, the effects of HIPc GM changes on the improvement of episodic memory were significantly mediated by HIPc connectivity with MTG.L changes in aMCI. Conclusion: This study provides novel experimental evidence about a biological substrate for the treatment of the disabling episodic memory in aMCI patients. Correction of breakdown in HIPc structure and its connectivity with MTG can causally ameliorate episodic memory in aMCI.
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Affiliation(s)
- Jiu Chen
- Institute of Neuropsychiatry>, the Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Rong Chen
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Chen Xue
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Guanjie Hu
- Institute of Neuropsychiatry>, the Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Wenwen Xu
- Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Rao
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
- Department of rehabilitation, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Fuquan Zhang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangrong Zhang
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Chow G, Gan JKE, Chan JKY, Wu XV, Klainin-Yobas P. Effectiveness of psychosocial interventions among older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021; 25:1986-1997. [PMID: 33200623 DOI: 10.1080/13607863.2020.1839861] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This review aimed to examine available evidence concerning the effectiveness of psychosocial interventions in improving memory, executive function, depression and activities of daily living (ADL) in older adults with MCI. METHODS Eight electronic databases were used to conduct a comprehensive literature search for published and unpublished studies. A primary outcome was cognitive function, including memory and executive function. Secondary outcomes were depression and ADL. Two researchers independently appraised quality of included studies and extracted data. Meta-analysis, heterogeneity test, subgroup analysis and sensitivity analyses were performed. RESULTS Ten studies (out of 1,265 records) were included in this review. Psychosocial interventions contributed to a significant improvement in memory, not executive function, depression and ADL. Subgroup analyses suggested that interventions with a longer duration, more therapeutic sessions, and individual format had larger effect sizes. Strategies found to enhance memory entailed behavior modification and activation, memory training, visual imagery, storytelling, memory aids, journaling, and exercise. CONCLUSION Healthcare providers may offer psychosocial interventions to client with MCI in clinical settings. Higher quality trials should be conducted to increase solid evidence in this domain.
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Affiliation(s)
- Gigi Chow
- Khoo Teck Puat Hospital, Singapore, Singapore
| | | | | | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
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Chang LH, Chen PY, Wang J, Shih BH, Tseng YH, Mao HF. High-Ecological Cognitive Intervention to Improve Cognitive Skills and Cognitive-Functional Performance for Older Adults With Mild Cognitive Impairment. Am J Occup Ther 2021; 75:14121. [PMID: 34780638 DOI: 10.5014/ajot.2021.041996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Evidence of the effectiveness of cognitive activity and preparatory tasks in improving the cognitive skills and functional performance of people with cognitive decline is limited. OBJECTIVE To examine the efficacy of a high-ecological cognitive intervention. DESIGN Quasi-experimental, pretest-posttest design with nonequivalent control. SETTING Community. PARTICIPANTS Older adults with mild cognitive impairment from two senior centers. INTERVENTION Twelve 90-min weekly group sessions of a high-ecological cognitive intervention using simulated everyday cognitive tasks (experimental group) and of nutrition education (active control group). Outcomes and Measures: Cognitive skills were measured with the Color Trails Test (CTT), the Contextual Memory Test (CMT; Immediate Recall [CMT-Im] and Delayed Recall [CMT-De] tasks), and the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span subtest (Digits Forward and Digits Backward). Cognitive-functional performance was measured with the Rivermead Behavioural Memory Test-Third Edition (RBMT-3; Immediate Recall [RBMT-3-Im] and Delayed Recall [RBMT-3-De] tasks) and the Cognitive Failures Questionnaire (CFQ). RESULTS Thirty-seven participants (M age = 70.84 yr; 70.3% women) met the inclusion criteria for analysis (20 participants in the intervention group, 17 participants in the control group). Multivariate linear regression showed that the intervention group improved significantly more than the control group on the CTT, CMT-Im, and RBMT-3-Im but not on the CMT-De, RBMT-3-De, and CFQ. CONCLUSIONS AND RELEVANCE Twelve 90-min weekly group sessions of a high-ecological cognitive intervention improved attention, executive function, immediate memory, and objective cognitive-functional performance with immediate-memory task demands. What This Article Adds: Carefully designed and structured simulated everyday cognitive tasks can be used as a cognitive training agent to improve both cognitive skills and objective cognitive-functional performance. The effectiveness of group-based cognitive interventions depends on the skills of occupational therapy practitioners in activity analysis and grading.
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Affiliation(s)
- Ling-Hui Chang
- Ling-Hui Chang, PhD, is Associate Professor, Department of Occupational Therapy and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Yen Chen
- Po-Yen Chen, MS, is Occupational Therapist, Department of Occupational Therapy, Jianan Psychiatric Center, Tainan, Taiwan
| | - Jye Wang
- Jye Wang, PhD, is Associate Professor, Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan
| | - Bin-Huei Shih
- Bin-Huei Shih, MS, is Doctoral Student, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hsuan Tseng
- Yu-Hsuan Tseng, BS, is Graduate Student, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Fen Mao
- Hui-Fen Mao, MS, is Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;
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Ameri N, Nobahar M, Ghorbani R, Bazghalee M, Sotodeh-Asl N, Babamohamadi H. Effect of reminiscence on cognitive impairment and depression in haemodialysis patients. J Ren Care 2021; 47:208-216. [PMID: 33423401 DOI: 10.1111/jorc.12359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cognitive impairment and depression are common problems in haemodialysis patients. AIM The present study was carried out to determine the impact of reminiscence on cognitive impairment and depression in haemodialysis patients. DESIGN This clinical trial (2016) was conducted with a pretest-posttest design on the haemodialysis patients of hospitals in Shahrud, Iran. PARTICIPANTS AND MEASUREMENTS Block random sampling was used to investigate the patients' cognitive status and Beck's Depression Scale were administered among 75 patients divided into intervention (given 12 sessions of Stinson's group reminiscence), control (group discussions), and sham (without any intervention) groups before, immediately and 30 days after the intervention. RESULTS Immediately and 30 days after the intervention, the cognitive score was significantly higher in the reminiscence group than the control (p < 0.001) and sham (p < 0.001) groups. Immediately after the intervention, the depression score was significantly lower in the reminiscence group than the control (p = 0.011) and sham (p < 0.001) groups. Also, immediately and 30 days after the intervention, the depression score was significantly lower in the reminiscence group than the control (p = 0.031) and sham (p < 0.001) groups. CONCLUSIONS The findings showed that reminiscence increased the cognitive health score and improved depression in haemodialysis patients. Therefore, reminiscence protocols can be utilized as an independent routine nursing care measure for improving cognitive status and depression in haemodialysis patients.
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Affiliation(s)
- Neda Ameri
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
| | - Raheb Ghorbani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Milad Bazghalee
- Department of Nursing, Faculty of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nemath Sotodeh-Asl
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
| | - Hassan Babamohamadi
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
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Mistler CB, Shrestha R, Gunstad J, Sanborn V, Copenhaver MM. Adapting behavioural interventions to compensate for cognitive dysfunction in persons with opioid use disorder. Gen Psychiatr 2021; 34:e100412. [PMID: 34504995 PMCID: PMC8370499 DOI: 10.1136/gpsych-2020-100412] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 07/21/2021] [Indexed: 01/20/2023] Open
Abstract
Treatment for opioid use disorder (OUD) is often in the context of biobehavioural interventions, consisting of medication for OUD (for example, methadone and buprenorphine), which is accompanied by psychoeducation and/or behavioural therapies. Patients with OUD often display weaknesses in cognitive function that may impact the efficacy of such behavioural interventions. A review of the literature was conducted to: (1) describe common cognitive dysfunction profiles among patients with OUD, (2) outline intervention approaches for patients with OUD, (3) consider the cognitive demands that interventions place on patients with OUD and (4) identify potential accommodation strategies that may be used to optimise treatment outcomes. Cognitive profiles of patients with OUD often include weaknesses in executive function, attention, memory and information processing. Behavioural interventions require the patients' ability to learn, understand and remember information (placing specific cognitive demands on patients). Accommodation strategies are, therefore, needed for patients with challenges in one or more of these areas. Research on accommodation strategies for patients with OUD is very limited. We applied research from populations with similar cognitive profiles to form a comprehensive collection of potential strategies to compensate for cognitive dysfunction among patients with OUD. The cognitive profiles and accommodation strategies included in this review are intended to inform future intervention research aimed at improving outcomes among patients with OUD.
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Affiliation(s)
- Colleen B Mistler
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Roman Shrestha
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - John Gunstad
- Department of Psychology, Kent State University, Kent, Ohio, USA
| | - Victoria Sanborn
- Department of Psychology, Kent State University, Kent, Ohio, USA
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Gómez-Soria I, Andrés Esteban EM, Gómez Bruton A, Peralta-Marrupe P. [Long-term effect analysis of a cognitive stimulation program in mild cognitive impairment elderly in Primary Care: A randomized controlled trial]. Aten Primaria 2021; 53:102053. [PMID: 33865010 PMCID: PMC8066353 DOI: 10.1016/j.aprim.2021.102053] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To provide evidence about the efficacy of a community health intervention through a cognitive stimulation program at long term in older people with mild cognitive impairment. DESIGN Randomized controlled trial (CONSORT group norms). LOCATION San José Norte-Centro Primary Care Center and La Caridad Foundation (Zaragoza, Spain). PARTICIPANTS Twenty-nine people over 65 years old with a 24-27 MEC score that completed 48 months follow up. They were randomized between the intervention group (15) and the control group (14). INTERVENTIONS The intervention was applied in 10 sessions of 45min for 10 weeks using the red notebook tool for mental activation that works memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention and executive functions. MAIN MEASUREMENTS The main outcome variables were MEC-35, Set-test, Barthel index, Lawton-Brody scale, Goldberg anxiety scale and Yesavage geriatric depression scale short form. RESULTS Increases of the main result variable over the baseline level of MEC-35 were analyzed. On average, the intervention group obtained higher scores than control: 3.14 points post intervention, 3.76 points after 6 months and 2.26 points more than control group after 12 months. All the differences were statistically significant. After 48 months the intervention group obtained 2 points more than control group. The intervention did not improve verbal fluency, activity daily living and mood. CONCLUSIONS Our cognitive stimulation program seems to improve cognitive performance, measured with the variable MEC-35 at post intervention, 6, 12 and 48 months. There is no evidence of improvement in verbal fluency, activity daily livings and mood. Clinicaltrials.gov Identifier: NCT03831061.
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Affiliation(s)
- Isabel Gómez-Soria
- Fundación La Caridad, Zaragoza, España; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| | - Eva María Andrés Esteban
- Grupo «Manejo del paciente sangrante» - IDIPaz (Hospital Universitario La Paz - Madrid). Universidad Rey Juan Carlos, Madrid, España
| | - Alejandro Gómez Bruton
- GENUD (Growth, Exercise, Nutrition and Development Research group), Departamento de Fisiatría y Enfermería, Área de Educación Física y Deportiva; Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Huesca, España
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Griffiths J, Thaikruea L, Wongpakaran N, Munkhetvit P, Kittisares A, Varnado P. Effects of Combined Physical Movement Activity and Multifaceted Cognitive Training in Older People with Mild Neurocognitive Disorder in a Rural Community: A Randomized Control Trial. Dement Geriatr Cogn Disord 2021; 49:194-201. [PMID: 32535601 DOI: 10.1159/000507922] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/14/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cognitive deterioration in older people with mild neurocognitive disorders (mNCD) increases the risk of progress to major NCD. Health professionals worldwide are trying to find strategies for prevention. There is a limited number of studies that deal with cultural conditions in northern Thailand. OBJECTIVES This study aimed to investigate the effects of a combination of physical movement activity and multifaceted cognitive training on cognitive function in older people with mNCD. METHODS A randomized control trial involving 70 mNCD people, according to DSM-5 criteria, was conducted on an intervention group and a control group (n = 35 each). The program for the intervention group included 24 sessions (twice a week). The outcome measures on cognitive function were assessed before and after the intervention by means of composite cognitive measures for older people, i.e., the Trail-Making Test (TMT), Digit Span (DS), Verbal Fluency (VF), Word-List Learning (WLL), and Block Design (BD). RESULTS The combined intervention enhanced cognitive function. TMT-A was significantly improved in the intervention group. There were significant improvements in DS sequence scores, letter verbal fluency (LVF), and category verbal fluency (CVF). Comparing the groups, there were significant differences in LVF including immediate and delayed recall. BD improved significantly in the intervention group. CONCLUSIONS The combined intervention appeared to be effective in delaying/preventing cognitive deterioration and cognitive functional decline in people with mNCD. Further studies on a variation of treatments suited to cultural conditions and their effects are needed. Trials in other communities are also recommended.
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Affiliation(s)
- Jiranan Griffiths
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Lakkana Thaikruea
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Peeraya Munkhetvit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Adisak Kittisares
- Sriphat Medical Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pairada Varnado
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Kim H, Hong JP, Kang JM, Kim WH, Maeng S, Cho SE, Na KS, Oh SH, Park JW, Cho SJ, Bae JN. Cognitive reserve and the effects of virtual reality-based cognitive training on elderly individuals with mild cognitive impairment and normal cognition. Psychogeriatrics 2021; 21:552-559. [PMID: 33934441 DOI: 10.1111/psyg.12705] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/24/2021] [Accepted: 04/14/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cognitive reserve (CR) is a concept proposed to account for discrepancies between the extent of brain pathology and clinical manifestations of that pathology. This study aimed to explore the associations between CR and the effects of cognitive training using fully immersive virtual reality (VR). METHODS A total of 44 older adults (22 cognitively normal, 22 with mild cognitive impairment) underwent eight cognitive training sessions using VR for a period of 4 weeks. CR was assessed using the Cognitive Reserve Index questionnaire (CRIq). To evaluate baseline cognitive function and the effects of VR training, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery was administered to all participants before and after the training. RESULTS Greater improvement in the total CERAD score was seen for cognitively normal participants with higher versus lower scores on the Education subdomain of the CRIq. Among patients with mild cognitive impairment, none of the CRIq subdomain scores (Education, Working Activity, Leisure Time) were related to a change in CERAD total scores. The CRIq total score did not predict the improvement of global cognition in either group. CONCLUSIONS This study revealed different impacts of CR on cognitive training according to the participants' cognitive status. It also suggests that employing three proxies of CR rather than using a composite score would provide a more accurate understanding of one's CR.
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Affiliation(s)
- Hyeyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gachon University College of Medicine Gil Medical Center, Incheon, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Seri Maeng
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Seo-Eun Cho
- Department of Psychiatry, Gachon University College of Medicine Gil Medical Center, Incheon, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University College of Medicine Gil Medical Center, Incheon, Republic of Korea
| | - Seok Hee Oh
- Department of Computer Engineering, Gachon University, Seongnam, Republic of Korea
| | - Jung Woon Park
- Department of IT Convergence Engineering, Gachon University Graduate School, Seongnam, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University College of Medicine Gil Medical Center, Incheon, Republic of Korea
| | - Jae Nam Bae
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
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Israsena P, Jirayucharoensak S, Hemrungrojn S, Pan-Ngum S. Brain Exercising Games With Consumer-Grade Single-Channel Electroencephalogram Neurofeedback: Pre-Post Intervention Study. JMIR Serious Games 2021; 9:e26872. [PMID: 34128816 PMCID: PMC8277357 DOI: 10.2196/26872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/27/2021] [Accepted: 04/17/2021] [Indexed: 01/19/2023] Open
Abstract
Background The aging population is one of the major challenges affecting societies worldwide. As the proportion of older people grows dramatically, so does the number of age-related illnesses such as dementia-related illnesses. Preventive care should be emphasized as an effective tool to combat and manage this situation. Objective The aim of this pilot project was to study the benefits of using neurofeedback-based brain training games for enhancing cognitive performance in the elderly population. In particular, aiming for practicality, the training games were designed to operate with a low-cost consumer-grade single-channel electroencephalogram (EEG) headset that should make the service scalable and more accessible for wider adoption such as for home use. Methods Our training system, which consisted of five brain exercise games using neurofeedback, was serviced at 5 hospitals in Thailand. Participants were screened for cognitive levels using the Thai Mental State Examination and Montreal Cognitive Assessment. Those who passed the criteria were further assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) computerized cognitive assessment battery. The physiological state of the brain was also assessed using 16-channel EEG. After 20 sessions of training, cognitive performance and EEG were assessed again to compare pretraining and posttraining results. Results Thirty-five participants completed the training. CANTAB results showed positive and significant effects in the visual memory (delayed matching to sample [percent correct] P=.04), attention (median latency P=.009), and visual recognition (spatial working memory [between errors] P=.03) domains. EEG also showed improvement in upper alpha activity in a resting state (open-eyed) measured from the occipital area (P=.04), which similarly indicated improvement in the cognitive domain (attention). Conclusions Outcomes of this study show the potential use of practical neurofeedback-based training games for brain exercise to enhance cognitive performance in the elderly population.
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Affiliation(s)
- Pasin Israsena
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Suwicha Jirayucharoensak
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Fitness Research Center, Chulalongkorn University, Bangkok, Thailand
| | - Setha Pan-Ngum
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
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Rizzi L, Aventurato ÍK, Balthazar MLF. Neuroimaging Research on Dementia in Brazil in the Last Decade: Scientometric Analysis, Challenges, and Peculiarities. Front Neurol 2021; 12:640525. [PMID: 33790850 PMCID: PMC8005640 DOI: 10.3389/fneur.2021.640525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
The last years have evinced a remarkable growth in neuroimaging studies around the world. All these studies have contributed to a better understanding of the cerebral outcomes of dementia, even in the earliest phases. In low- and middle-income countries, studies involving structural and functional neuroimaging are challenging due to low investments and heterogeneous populations. Outstanding the importance of diagnosing mild cognitive impairment and dementia, the purpose of this paper is to offer an overview of neuroimaging dementia research in Brazil. The review includes a brief scientometric analysis of quantitative information about the development of this field over the past 10 years. Besides, discusses some peculiarities and challenges that have limited neuroimaging dementia research in this big and heterogeneous country of Latin America. We systematically reviewed existing neuroimaging literature with Brazilian authors that presented outcomes related to a dementia syndrome, published from 2010 to 2020. Briefly, the main neuroimaging methods used were morphometrics, followed by fMRI, and DTI. The major diseases analyzed were Alzheimer's disease, mild cognitive impairment, and vascular dementia, respectively. Moreover, research activity in Brazil has been restricted almost entirely to a few centers in the Southeast region, and funding could be the main driver for publications. There was relative stability concerning the number of publications per year, the citation impact has historically been below the world average, and the author's gender inequalities are not relevant in this specific field. Neuroimaging research in Brazil is far from being developed and widespread across the country. Fortunately, increasingly collaborations with foreign partnerships contribute to the impact of Brazil's domestic research. Although the challenges, neuroimaging researches performed in the native population regarding regional peculiarities and adversities are of pivotal importance.
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Affiliation(s)
- Liara Rizzi
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
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Chen Y, Wang J, Cui C, Su Y, Jing D, Wu L, Liang P, Liang Z. Evaluating the association between brain atrophy, hypometabolism, and cognitive decline in Alzheimer's disease: a PET/MRI study. Aging (Albany NY) 2021; 13:7228-7246. [PMID: 33640881 PMCID: PMC7993730 DOI: 10.18632/aging.202580] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022]
Abstract
Glucose metabolism reduction and brain volume losses are widely reported in Alzheimer’s disease (AD). Considering that neuroimaging changes in the hippocampus and default mode network (DMN) are promising important candidate biomarkers and have been included in the research criteria for the diagnosis of AD, it is hypothesized that atrophy and metabolic changes of the abovementioned regions could be evaluated concurrently to fully explore the neural mechanisms underlying cognitive impairment in AD. Twenty-three AD patients and Twenty-four age-, sex- and education level-matched normal controls underwent a clinical interview, a detailed neuropsychological assessment and a simultaneous 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET)/high-resolution T1-weighted magnetic resonance imaging (MRI) scan on a hybrid GE SIGNA PET/MR scanner. Brain volume and glucose metabolism were examined in patients and controls to reveal group differences. Multiple linear regression models were employed to explore the relationship between multiple imaging features and cognitive performance in AD. The AD group had significantly reduced volume in the hippocampus and DMN regions (P < 0.001) relative to that of normal controls determined by using ROI analysis. Compared to normal controls, significantly decreased metabolism in the DMN (P < 0.001) was also found in AD patients, which still survived after controlling for gray matter atrophy (P < 0.001). These findings from ROI analysis were further confirmed by whole-brain confirmatory analysis (P < 0.001, FWE-corrected). Finally, multiple linear regression results showed that impairment of multiple cognitive tasks was significantly correlated with the combination of DMN hypometabolism and atrophy in the hippocampus and DMN regions. This study demonstrated that combining functional and structural features can better explain the cognitive decline of AD patients than unimodal FDG or brain volume changes alone. These findings may have important implications for understanding the neural mechanisms of cognitive decline in AD.
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Affiliation(s)
- Yifan Chen
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Junkai Wang
- Department of Psychology, Tsinghua University, Beijing, China.,School of Psychology, Capital Normal University, Beijing, China.,Beijing Key Laboratory of Learning and Cognition, Beijing, China
| | - Chunlei Cui
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yusheng Su
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Donglai Jing
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - LiYong Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peipeng Liang
- School of Psychology, Capital Normal University, Beijing, China.,Beijing Key Laboratory of Learning and Cognition, Beijing, China
| | - Zhigang Liang
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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Efficacy of cognitive intervention programs in amnesic mild cognitive impairment: A systematic review. Arch Gerontol Geriatr 2021; 94:104332. [PMID: 33486120 DOI: 10.1016/j.archger.2020.104332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Amnesic mild cognitive impairment (aMCI) is considered a prodromal stage of Alzheimer's disease. Given the absence of an effective pharmacological treatment for aMCI, increasing numbers of studies are attempting to understand how cognitive interventions could benefit aMCI patients. The aim of this systematic review was to evaluate the current evidence regarding the efficacy on cognition of cognitive intervention programs in older adults with aMCI. METHODS We searched for randomized controlled trials and clinical trials published until March 2020 on PubMed, Web of Science, Cochrane Library, SCOPUS, and OTseeker. A total of 454 works were identified and 7 studies that met the inclusion criteria, were included in this review. PRISMA guidelines were followed and PEDro scale was included for the measurement of the quality of the selected studies. RESULTS Cognitive interventions showed positive effects on cognition. Cognitive training programs considerably enhanced the Mini Mental State Examination scores. However, no relevant differences in global cognition were found using other assessment tools as DRS-2 or ADAS-Cog Scale. Cognitive training and cognitive rehabilitation programs seemed to improve several cognitive domains as memory, language or executive function in aMCI patients in both post-training and at follow-up analysis. CONCLUSIONS Our findings support that cognitive interventions can be an effective option for people with aMCI. Cognitive interventions improved global cognitive function post-intervention, but also seemed to enhance some cognitive domains post-intervention and at follow-up. However, more studies are needed to analyze the potential benefits of cognitive intervention on aMCI.
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Preventing dementia? Interventional approaches in mild cognitive impairment. Neurosci Biobehav Rev 2021; 122:143-164. [PMID: 33440197 DOI: 10.1016/j.neubiorev.2020.12.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/13/2020] [Accepted: 12/19/2020] [Indexed: 12/19/2022]
Abstract
Mild cognitive impairment (MCI) is defined as an intermediate state between normal cognitive aging and dementia. It describes a status of the subjective impression of cognitive decline and objectively detectible memory impairment beyond normal age-related changes. Activities of daily living are not affected. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the well-being of people with MCI and their caregivers. Various forms and approaches of intervention for older people with MCI have been suggested to delay cognitive decline. Pharmacological as well as non-pharmacological approaches (cognitive, physiological, nutritional supplementation, electric stimulation, psychosocial therapeutic) and multicomponent interventions have been proposed. Interventional approaches in MCI from 2009 to April 2019 concerning the cognitive performance are presented in this review.
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Cognitive Improvement Effects of Electroacupuncture Combined with Computer-Based Cognitive Rehabilitation in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial. Brain Sci 2020; 10:brainsci10120984. [PMID: 33327627 PMCID: PMC7765117 DOI: 10.3390/brainsci10120984] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/12/2022] Open
Abstract
This outcome assessor-blinded, randomized controlled clinical trial investigated the effects of electroacupuncture combined with computer-based cognitive rehabilitation (EA-CCR) on mild cognitive impairment (MCI). A per-protocol analysis was employed to compare the efficacy of EA-CCR to that of computer-based cognitive rehabilitation (CCR). Thirty-two patients with MCI completed the trial (EA-CCR group, 16; CCR group, 16). Patients received EA-CCR or CCR treatment once daily three days per week for eight weeks. Outcome (primary, ADAS-K-cog; secondary, MoCA-K, CES-D, K-ADL, K-IADL, and EQ-5D-5L) measurements were performed at baseline (week 0), at the end of the intervention (week 8), and at 12 weeks after completion of the intervention (week 20). Both groups showed significant changes in ADAS-K-cog score (EA-CCR, p < 0.001; CCR, p < 0.001) and MoCA-K (EA-CCR, p < 0.001; CCR, p < 0.001). Only the EA-CCR group had a significant change in CES-D (p = 0.024). No significant differences in outcomes and in the results of a subanalysis based on age were noted between the groups. These results indicate that EA-CCR and CCR have beneficial effects on improving cognitive function in patients with MCI. However, electroacupuncture in EA-CCR showed no positive add-on effects on improving cognitive function, depression, activities of daily living, and quality of life in patients with MCI.
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Chen J, Ma N, Hu G, Nousayhah A, Xue C, Qi W, Xu W, Chen S, Rao J, Liu W, Zhang F, Zhang X. rTMS modulates precuneus-hippocampal subregion circuit in patients with subjective cognitive decline. Aging (Albany NY) 2020; 13:1314-1331. [PMID: 33260151 PMCID: PMC7835048 DOI: 10.18632/aging.202313] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022]
Abstract
Hippocampal subregions (HIPsub) and their network connectivities are generally aberrant in patients with subjective cognitive decline (SCD). This study aimed to investigate whether repetitive transcranial magnetic stimulation (rTMS) could ameliorate HIPsub network connectivity by modulating one node of HIPsub network in SCD. In the first cohort, the functional connectivity (FC) of three HIPsub (i.e., hippocampal emotional, cognitive, and perceptual regions: HIPe, HIPc, and HIPp) were analyzed so as to identify alterations in HIPsub connectivity associated with SCD. Afterwards, a support vector machine (SVM) approach was applied using the alterations in order to evaluate to what extent we could distinguish SCD from healthy controls (CN). In the second cohort, a 2-week rTMS course of 5-day, once-daily, was used to activate the altered HIPsub network connectivity in a sham-controlled design. SCD subjects exhibited distinct patterns alterations of HIPsub network connectivity compared to CN in the first cohort. SVM classifier indicated that the abnormalities had a high power to discriminate SCD from CN, with 92.9% area under the receiver operating characteristic curve (AUC), 86.0% accuracy, 83.8% sensitivity and 89.1% specificity. In the second cohort, changes of HIPc connectivity with the left parahippocampal gyrus and HIPp connectivity with the left middle temporal gyrus demonstrated an amelioration of episodic memory in SCD after rTMS. In addition, SCD exhibited improved episodic memory after the rTMS course. rTMS therapy could improve the posterior hippocampus connectivity by modulating the precuneus in SCD. Simultaneous correction of the breakdown in HIPc and HIPp could ameliorate episodic memory in SCD. Thus, these findings suggested that rTMS manipulation of precuneus-hippocampal circuit might prevent disease progression by improving memory as the earliest at-risk state of Alzheimer’s disease in clinical trials and in practice.
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Affiliation(s)
- Jiu Chen
- Institute of Neuropsychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China
| | - Nan Ma
- Department of Neurology, Xi'an Children's Hospital, Xi'an 710003, Shaanxi, China
| | - Guanjie Hu
- Institute of Neuropsychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China
| | - Amdanee Nousayhah
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chen Xue
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wenzhang Qi
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wenwen Xu
- Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Shanshan Chen
- Department of Neurology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Jiang Rao
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Rehabilitation, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wan Liu
- Department of Rehabilitation, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Fuquan Zhang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiangrong Zhang
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing 210029, China.,Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
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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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Wu J, Ma Y, Ren Z. Rehabilitative Effects of Virtual Reality Technology for Mild Cognitive Impairment: A Systematic Review With Meta-Analysis. Front Psychol 2020; 11:1811. [PMID: 33101098 PMCID: PMC7545425 DOI: 10.3389/fpsyg.2020.01811] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 07/01/2020] [Indexed: 12/19/2022] Open
Abstract
Objective: To evaluate the impact of virtual reality (VR) technology on the cognitive functions (overall cognitive ability, executive function, short-term memory, and long-term memory) of people with mild cognitive impairment (MCI). Methods: All major databases, including Web of Science, PubMed, Scopus, Proquest, WanFang, and CNKI, were searched to identify all relevant studies published in English or Chinese since October 28th, 2019. Two researchers independently conducted document retrieval, study selection, data extraction, and methodological quality evaluation. Result: 15 randomized controlled trials were analyzed (N = 612 people with MCI), with the methodological quality evaluation score ranging from 5 to 7 points. A random effects model was selected to combine effect sizes. The result of the meta-analysis indicates that VR significantly enhanced MCI patients' overall cognitive ability (SMD = 0.869, 95% confidence interval [CI] = 0.330–1.407, P = 0.002, I2 = 86.822, n = 537) and executive function (SMD = 1.083, 95%, 95%CI = 00.134–2.031, P = 0.025, I2 = 93.748, n = 220). The meta-analysis indicated that after VR training, effects on short-term memory (SMD = 0.488, 95%CI = −0.108–1.084, P = 0.109, I2 = 62.354, n = 131) and long-term memory (SMD = 0.335, 95%CI = −1.194–0.863, P = 0.0.214, I2 = 58.868, n = 152) were not statistically significant. Conclusions: The present meta-analysis verifies the potential rehabilitative effects of VR technology for mild cognitive impairment.
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Affiliation(s)
- Jinlong Wu
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Yudan Ma
- Jilin Institute of Sport Science, Changchun, China
| | - Zhanbing Ren
- Department of Physical Education, Shenzhen University, Shenzhen, China
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Sanjuán M, Navarro E, Calero MD. Effectiveness of Cognitive Interventions in Older Adults: A Review. Eur J Investig Health Psychol Educ 2020; 10:876-898. [PMID: 34542517 PMCID: PMC8314287 DOI: 10.3390/ejihpe10030063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Introduction: With older adults, cognitive intervention programs are most often used for preventing or reversing a decline in cognitive functions, but it has been recently noted that there are insufficient high-quality research studies that report the effects of cognitive intervention on the cognitive functioning of older adults. (2) Objective: To analyze the available evidence concerning the effect of cognitive interventions for improving or maintaining the general cognitive status of older adults who present different cognitive levels. (3) Method: a review of studies published between 2010 and 2019 using the following databases: PubMed, PsycINFO, Cochrane, Google Scholar, ProQuest and Medline. (4) Results: We selected 13 systematic reviews and/or meta-analyses. The results showed that the cognitive intervention programs improved general cognitive functioning and specific cognitive functions regardless of the initial cognitive level; that cognitive decline was slowed in older persons with dementia; and there was improvement in activities of daily living. Regarding duration of the results, benefits were maintained for periods of 2 months to 5 years. (5) Conclusion: Cognitive interventions have proven effective for maintaining and/or improving cognitive functioning in older adults regardless of their initial cognitive status. Even so, there are few studies that follow up these results to see whether they are maintained in the long term and whether there is transfer to other skills of daily life. However, we were able to observe in the present review how the participants' cognitive level varied according to sociodemographic differences, and to identify which components of cognitive programs make them more effective. Based on the results found, we highlight the importance of designing cognitive intervention programs that meet these effectiveness criteria, in order to maximize the positive effects of such programs when working with a population of older adults.
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Affiliation(s)
- Miriam Sanjuán
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain;
| | - Elena Navarro
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain;
- Research Center on Mind, Brain and Behavior (CIMCYC), Campus de Cartuja s/n, University of Granada, 18071 Granada, Spain;
| | - M. Dolores Calero
- Research Center on Mind, Brain and Behavior (CIMCYC), Campus de Cartuja s/n, University of Granada, 18071 Granada, Spain;
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Martin DM, Mohan A, Alonzo A, Gates N, Gbadeyan O, Meinzer M, Sachdev P, Brodaty H, Loo C. A Pilot Double-Blind Randomized Controlled Trial of Cognitive Training Combined with Transcranial Direct Current Stimulation for Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2020; 71:503-512. [PMID: 31424410 DOI: 10.3233/jad-190306] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is currently no effective intervention for improving memory in people at increased risk for dementia. Cognitive training (CT) has been promising, though effects are modest, particularly at follow-up. OBJECTIVE To investigate whether adjunctive non-invasive brain stimulation (transcranial direct current stimulation, tDCS) could enhance the memory benefits of CT in amnestic mild cognitive impairment (aMCI). METHODS Participants with aMCI were randomized to receive CT with either Active tDCS (2 mA for 30 min and 0.016 mA for 30 min) or Sham tDCS (0.016 mA for 60 min) for 15 sessions over a period of 5 weeks in a double-blind, sham-controlled, parallel group clinical trial. The primary outcome measure was the California Verbal Learning Task 2nd Edition. RESULTS 68 participants commenced the intervention. Intention-to-treat (ITT) analysis showed that the CT+Active tDCS group significantly improved at post treatment (p = 0.033), and the CT+Sham tDCS group did not (p = 0.050), but there was no difference between groups. At the 3-month follow-up, both groups showed large-sized memory improvements compared to pre-treatment (CT+Active tDCS: p < 0.01, d = 0.99; CT+Sham tDCS: p < 0.01, d = 0.74), although there was no significant difference between groups. CONCLUSION This study found that CT+Active tDCS did not produce greater memory improvement compared to CT+Sham tDCS. Large-sized memory improvements occurred in both conditions at follow-up. One possible interpretation, based on recent novel findings, is that low intensity tDCS (used as 'sham') may have contributed biological effects. Further work should use a completely inert tDCS sham condition.
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Affiliation(s)
- Donel M Martin
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Adith Mohan
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Angelo Alonzo
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Nicola Gates
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Oyetunde Gbadeyan
- University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Marcus Meinzer
- University of Queensland Centre for Clinical Research, Brisbane, Australia.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Perminder Sachdev
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Colleen Loo
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia.,St George Hospital, South Eastern Sydney Health, Sydney, Australia
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Sherman DS, Durbin KA, Ross DM. Meta-Analysis of Memory-Focused Training and Multidomain Interventions in Mild Cognitive Impairment. J Alzheimers Dis 2020; 76:399-421. [PMID: 32508325 DOI: 10.3233/jad-200261] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Meta-analysis examining the efficacy of cognitive interventions on neuropsychological outcomes have suggested interventions that focus on memory may actually provide greater benefit against the cognitive declines associated with mild cognitive impairment (MCI). However, it remains unclear if memory-based training would be more effective at addressing the cognitive deficits associated with MCI than multidomain forms of intervention. OBJECTIVE A meta-analytic review and subgroup analysis was conducted to examine the effects of cognitive training in individuals diagnosed with MCI and to compare the efficacy of memory-based training with multidomain interventions. METHODS A total of 32 randomized controlled trials met inclusion criteria for the meta-analysis, which included 9 studies on memory-focused training and 17 studies on multidomain interventions. RESULTS We found significant, large effects for memory-focused training (Hedges' g observed = 0.947; 95% CI [-1.668, 3.562]; Z = 2.517; p = 0.012) and significant, moderate effects for multidomain interventions (Hedges' g observed = 0.420; 95% CI [-0.4491, 1.2891]; Z = 3.525; p < 0.001). A subgroup analysis found significant point estimates for memory-based forms of training and multidomain interventions, with memory-based forms of content yielding significantly greater summary effects than multidomain interventions (SMD Z = 2.162; p = 0.031, two-tailed; all outcomes). There was no difference between effect sizes when comparing outcomes limited to its respective domain. CONCLUSION Overall, these findings suggest that, while both interventions were beneficial, treatment interventions that were strictly memory-based were more effective at improving cognition in individuals diagnosed with MCI than interventions that targeted multiple cognitive domains.
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Affiliation(s)
- Dale S Sherman
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Rossier School of Education, University of Southern California, Los Angeles, CA, USA
| | - Kelly A Durbin
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - David M Ross
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, Loma Linda University, Loma Linda, CA, USA
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Simon SS, Castellani M, Belleville S, Dwolatzky T, Hampstead BM, Bahar‐Fuchs A. The design, evaluation, and reporting on non-pharmacological, cognition-oriented treatments for older adults: Results of a survey of experts. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12024. [PMID: 32523978 PMCID: PMC7276188 DOI: 10.1002/trc2.12024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 03/11/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Cognitive decline and dementia significantly affect independence and quality of life in older adults; therefore, it is critical to identify effective cognition-oriented treatments (COTs; eg, cognitive training, rehabilitation) that can help maintain or enhance cognitive functioning in older adults, as well as reduce dementia risk or alleviate symptoms associated with pathological processes. METHODS The Cognitive Intervention Design Evaluation and Reporting (CIDER), a working group from the Non-Pharmacological Interventions Professional Interest Area (NPI-PIA) of the Alzheimer's Association conducted as survey in 2017 with experts in COTs worldwide. The survey's aims were three-fold: (1) determine the common attitudes, beliefs, and practices of experts involved in the COTs research targeting older people; (2) identify areas of relative agreement and disagreement among experts in the field; and (3) offer a critical review of the literature, including recommendations for future research. RESULTS The survey identified several areas of agreements among experts on critical features of COTs, and on study design and outcome measures. Nevertheless, there were some areas with relative disagreement. Critically, expert opinions were not always supported by scientific evidence, suggesting that methodologic improvements are needed regarding design, implementation, and reporting of COTs. There was a clear consensus that COTs provide benefits and should be offered to cognitively unimpaired older adults, mild cognitive impairment (MCI), and mild dementia, but opinions differed for moderate and severe dementia. In addition, there is no consensus on the potential role of COTs in dementia prevention, indicating that future research should prioritize this aspect. DISCUSSION Evidence of COTs in older adults is encouraging, but additional evidence is needed to enhance dementia prevention. Consensus building and guidelines in the field are critical to improve and accelerate the development of high-quality evidence for COTs in cognitively unimpaired older adults, and those with MCI and dementia.
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Affiliation(s)
- Sharon Sanz Simon
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityNew YorkNew York
- Old Age Research Group (PROTER)Department of PsychiatrySão Paulo Medical SchoolUniversity of São PauloSão PauloBrazil
| | - Mary Castellani
- Academic Unit for Psychiatry of Old AgeDepartment of PsychiatryUniversity of MelbourneMelbourneAustralia
| | - Sylvie Belleville
- Psychology DepartmentUniversité de MontréalMontrealCanada
- Research CenterInstitut Universitaire de Gériatrie de MontréalMontrealCanada
| | - Tzvi Dwolatzky
- Rambam Health Care Campus and Rappaport Faculty of MedicineTechnion—Israel Institute of TechnologyHaifaIsrael
| | - Benjamin M. Hampstead
- Mental Health ServiceVA Ann Arbor Healthcare SystemAnn ArborMichigan
- Neuropsychology SectionDepartment of PsychiatryUniversity of MichiganAnn ArborMichigan
| | - Alex Bahar‐Fuchs
- Academic Unit for Psychiatry of Old AgeDepartment of PsychiatryUniversity of MelbourneMelbourneAustralia
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Brydges CR, Liu-Ambrose T, Bielak AAM. Using intraindividual variability as an indicator of cognitive improvement in a physical exercise intervention of older women with mild cognitive impairment. Neuropsychology 2020; 34:825-834. [PMID: 32338944 DOI: 10.1037/neu0000638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Intervention programs designed to improve cognitive ability in older adults with mild cognitive impairment (MCI) have often focused on physical exercise as a means to improve traditional measures of cognition, with mixed success. Individuals with MCI show high levels of intraindividual variability (IIV) in response speed, and IIV may be sensitive to intervention-related changes. The current study evaluated if participants who participated in a physical activity intervention (aerobic or resistance training) showed a reduction in IIV, compared to a balance and tone control group. METHOD This study was a secondary analysis of the EXercise for Cognition and Everyday Living (EXCEL) Study. Women Aged 70-80 years with probable MCI (n = 86) participated in a 6-month randomized controlled trial designed to investigate the effects of different physical exercises on cognitive ability. Participants completed 1-back, task switching, and spatial working memory tasks at baseline, 13 weeks (midpoint) and upon completion of the program. RESULTS Analyses were conducted following both the intent-to-treat principle and complier average casual effect (CACE) modeling. Participants in the intervention group who complied with the program showed reduced IIV on task switching in the CACE models. The intent-to-treat analyses were all nonsignificant. CONCLUSIONS Physical exercise resulted in improved IIV in older adults with probable MCI, showing that IIV is modifiable by lifestyle engagement. IIV may be a useful complementary index of cognitive plasticity particularly among those with cognitive impairment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Hong YJ, Lee JH, Choi EJ, Han N, Kim JE, Park SH, Kim HJ, Kang DW. Efficacies of Cognitive Interventions in the Elderly with Subjective Cognitive Decline: A Prospective, Three-Arm, Controlled Trial. J Clin Neurol 2020; 16:304-313. [PMID: 32319248 PMCID: PMC7174106 DOI: 10.3988/jcn.2020.16.2.304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/02/2020] [Accepted: 02/07/2020] [Indexed: 01/05/2023] Open
Abstract
Background and Purpose A cognitive intervention (CI) is thought to improve cognition and delay cognitive decline via neuronal plasticity and cognitive resilience. Subjective cognitive decline (SCD) might be the first symptomatic stage of Alzheimer's disease, but few studies have examined the beneficial effect of CIs in SCD. We aimed to determine the efficacy of a 12-week, small-group-based, multidomain CI in elderly patients with SCD. Methods Participants diagnosed with SCD (aged 55–75 years) were consecutively allocated to three groups: group 1, which received group-based CI implementation with lifestyle modifications; group 2, which received home-based lifestyle modifications without CI; and group 3, in which no action was taken. The primary outcome variables were the scores on computerized tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). The secondary outcomes included scores on tests evaluating general cognition, memory, visuospatial, and executive functions, as well as scores for the quality of life (QoL), anxiety, depression, and degree of subjective complaints. Changes in scores during the study period were compared between groups. Results The study was completed by 56 SCD participants. The baseline characteristics did not differ among the groups. The primary outcomes (CANTAB scores) did not differ among the groups. However, the outcomes for phonemic word fluency, verbal memory, QoL, and mood were better for group 1 than for the other two groups. Improvements in verbal memory function and executive function were related to the baseline cognitive scores and group differences. Conclusions CI in SCD seems to be partially beneficial for executive function, memory, QoL, and mood, suggesting that CI is a useful nonpharmacological treatment option in this population.
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Affiliation(s)
- Yun Jeong Hong
- Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Eun Ji Choi
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Noel Han
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Eun Kim
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - So Hee Park
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyung Ji Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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The Efficacy of Cognitive Training for Elderly Chinese Individuals with Mild Cognitive Impairment. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4347281. [PMID: 31886216 PMCID: PMC6907055 DOI: 10.1155/2019/4347281] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/11/2019] [Indexed: 01/06/2023]
Abstract
The age of the population is shifting toward the elderly range, which may lead to an increased risk of mild cognitive impairment (MCI). The aims of this study are to evaluate the cognitive function in elderly people using the Montreal Cognitive Assessment (MoCA), to identify the relationship between cognitive function and different characteristics, and to evaluate the efficacy of the intervention after six months of cognitive training. In this study, we included 2886 subjects aged ≧60 years in the baseline survey, and 140 subjects with MCI who participated in the baseline survey were randomly divided into an intervention group (N = 70) and a control group (N = 70). The control group was not provided any intervention measures, and the intervention group was administered cognitive training. The education level, monthly income, sleep time, exercise time, reading times, and time spent engaging in community activities and performing housework were positively correlated with MoCA scores, but age was negatively correlated with MoCA scores. The total MoCA score of the intervention group increased from 19.77 ± 2.24 points to 21.09 ± 2.20 points after six months of cognitive training, but the score of the control group decreased from 20.41 ± 2.10 points to 19.17 ± 2.57 points. The two-way repeated-measures ANOVA revealed a very significant effect of the interaction between time and cognitive training on the total MoCA score. Seventeen participants in the intervention group improved to normal levels, and no participants progressed to dementia after six months of cognitive training. Thus, the efficacy of the intervention was statistically significant. Our study concludes that older age is associated with a cognitive decline. Factors that are more likely to protect against cognitive decline included a higher education level and monthly income, sufficient sleep time, regular physical exercise and reading, frequently engaging in community activities, and continuing to perform housework. Moreover, the cognitive training intervention is effective and may help to decrease the deterioration of cognitive function in patients with MCI, and the interaction between intervention time and cognitive training significantly improves cognitive function.
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