Maintaining older brain functionality: A targeted review

Effects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations: a systematic review and meta-analysis protocol

BACKGROUND

Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults.

METHODS AND ANALYSIS

The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R.

DISCUSSION AND CONCLUSION

This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022367111.

Considering the response in addition to the challenge - a narrative review in appraisal of a motor reserve framework

The remarkable increase in human life expectancy over the past century has been achieved at the expense of the risk of age-related impairment and disease. Neurodegeneration, be it part of normal aging or due to neurodegenerative disorders, is characterized by loss of specific neuronal populations, leading to increasing clinical impairment. The individual course may be described as balance between aging- or disease-related pathology and intrinsic mechanisms of adaptation. There is plenty of evidence that the human brain is provided with exhaustible resources to maintain function in the face of adverse conditions. While a reserve concept has mainly been coined in cognitive neuroscience, emerging evidence suggests similar mechanisms to underlie individual differences of adaptive capacity within the motor system. In this narrative review, we summarize what has been proposed to date about a motor reserve (mR) framework. We present current evidence from research in aging subjects and people with neurological conditions, followed by a description of what is known about potential neuronal substrates of mR so far. As there is no gold standard of mR quantification, we outline current approaches which describe various indicators of mR. We conclude by sketching out potential future directions of research. Expediting our understanding of differences in individual motor resilience towards aging and disease will eventually contribute to new, individually tailored therapeutic strategies. Provided early diagnosis, enhancing the individual mR may be suited to postpone disease onset by years and may be an efficacious contribution towards healthy aging, with an increased quality of life for the elderly.

Impulsivity and attention deficit-hyperactivity symptoms among patients with relapsing-remitting multiple sclerosis: a case-control study

BACKGROUND AND OBJECTIVES

Multiple sclerosis(MS) is a progressive, autoimmune, neurodegenerative disease.Studies have suggested that autoimmune diseases play a role in the pathogenesis of Attention deficit and hyperactivity disorder(ADHD).We aim to evaluate ADHD symptoms among patients with RRMS(pwRRMS).

METHODS

The study included 48 RRMS patients and 54 healthy controls. ADHD symptoms were assessed by self-report questionnaires and performance tests.Beck Depression Inventory (BDI), Turgay's Turkish version of Adult-ADD/ADHD (A-ADHD), Barratt Impulsivity Scale (BIS-11), and World Health Organization Quality of Life-Short Form (WHOQoL-Bref) were completed by the participants.Stroop Colour and Word Interference Test - TBAG Form (SCWT); was used for assessing cognitive function by a trained psychiatrist. Fatigue Severity Scale (FSS) and Expanded Disability Status Scale (EDSS) were used to evaluate by pwRRMS.

RESULTS

PwRRMS had significantly higher attention-deficit scores and poor performance in all SCWT subtests.All SCWT scores were positively correlated with MS duration.A-ADHD-Total scores were negatively correlated with the age of MS diagnosis.A moderate positive correlation was found between falls and A-ADHD-total scores, and psychomotor speed.A moderate negative correlation was found between WHOQoL-Bref scores and BID, FSS, ADHD-Attention Deficit, SCWT-3, SCWT-5, and SCWT-interference.In multivariate linear regression analyzes, attention-deficit predicted EDSS positively, while depressive symptoms, attention-deficit, and psychomotor speed time were negative predictors of physical health quality.

CONCLUSIONS

In pwRRMS, cognitive dysfunctions such as response inhibition and intervention control, which are symptoms of attention deficit and impulsivity, have been shown to reduce the overall QoL. Among the strategies to reduce the impact of RRMS disease on patients' lives, it is essential to implement programs to prevent depression and increase cognitive reserve.

Positive effects of brisk walking and Tai Chi on cognitive function in older adults: An fNIRS study

Exercise has shown to have beneficial effects on cognition in older adults. The purpose of this study was to investigate the cortical hemodynamic responses during the word-color Stroop test (WCST) prior and after acute walking and Tai Chi exercise by functional near-infrared spectroscopy (fNIRS). Twenty participants (9 males, mean age 62.8 ± 5.2), first underwent a baseline WCST test, after which they took three WCST tests in a randomized order, (a) after sitting rest (control), (b) after 6 minutes performing Tai Chi Quan, and (c) after a bout of 6 minutes brisk walking. During these four WCST tests cortical hemodynamic changes in the prefrontal area were monitored with fNIRS. Both brisk walking and Tai Chi enhanced hemodynamic activity during the Stroop incongruent tasks, leading to improved cognitive performance (quicker reaction time). Brisk walking induced a greater hemodynamic activity in the right dorsolateral prefrontal cortex (DLPFC) and ventrolateral prefrontal cortex (VLPFC) area, whereas Tai Chi induced a greater bilateral hemodynamic activity in the DLPFC and VLPFC areas. The present study provided empirical evidence of enhanced hemodynamic response in task- specific regions of the brain that can be achieved by a mere six minutes of brisk walking or Tai Chi in older adults.

Evidence-based cognitive retraining in elderly depressives

Background

Aging is a normal biological process, and its dynamic changes are beyond the control of human beings. The role of depression, fear, and anxiety in old age is preoccupied with unhappy thoughts, and loneliness leads to early deterioration in their cognitive performance which makes it difficult to perform daily activities and hence affects their quality of life.

Aim

The present study was done to assess the effectiveness of cognitive retraining in elderly depressives and its effect on their quality of life.

Materials and Methods

The study was done on a sample of 20 depressive elderly patients with an age range above 60 years diagnosed with ICD-10 criteria. The study was pre- and post-intervention, and the sampling method was purposive. Firstly to screen handedness, Annet's hand preference battery was used, to assess the depression in elderly, the geriatric depression scale was done, and for attention and memory, Digit Span Test (WAIS-R) and Wechsler Memory Scale (WMS) were administered, respectively. WHO-QOL BREF was done to know the quality of life of the patient. After preassessment, cognitive retraining tasks were introduced to the patients. A total of 15 sessions were taken within three months of follow-up and after that to evaluate the efficacy of an outcome of the cognitive retraining, post-assessment was done.

Results

Improvement was noticed in elderly depressive patients in the area of cognitive domain, i.e., attention, recognition, shifting, fixedness, recall, and planning which showed improvement in quality of life and daily activities.

Conclusion

In the remediation of cognitive deficits, cognitive retraining plays a very important role, and it helps the elderly population to live their life healthily and hence enhance their coping skills.

Effects of cognitive and stress management training in middle-aged and older industrial workers in different socioeconomic settings: a randomized controlled study

Introduction

The demographic change requires longer working lifetime. However, fear of job loss may lead to chronic stress whereas aging and unchallenging work may accelerate cognitive decline and early retirement. Long-time repetitive work led to impairments of cognitive functions in middle-aged and older employees, as demonstrated in a previous study conducted in a large car manufacturer. In the present study, a training concept was implemented to enhance the cognitive and emotional competence of these employees.

Methods

A first group of employees received a trainer-guided cognitive training only, whereas a wait list control group received a cognitive training and stress management training. This design was applied in two independent samples separated by one year either during or after a socioeconomically tense situation of the factory.

Results

In sample 1, with a tense occupational situation, the cognitive training effects occurred with a delay of three months. In contrast, in sample 2, with less critical socioeconomic situation, the training effects occurred immediately and persisted three months later. Stress management training showed reduction of subjectively and objectively measured stress level.

Discussion

The results indicate that effects of cognitive interventions are diminished under chronic stress which can be reduced after a short stress management training. This leads also to enhanced attention and memory in daily life. In contrast, in Sample 2 with less chronic stress, effects of cognitive training were stronger and persisted at least three months later, whereas stress management training had less impact. This suggests that cognitive learning in occupational settings is only efficient at lower stress levels.

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

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.

Does physical fitness affect cognitive functions differently across adulthood? An advantage of being older

Introduction

There is a large interindividual variability in cognitive functioning with increasing age due to biological and lifestyle factors. One of the most important lifestyle factors is the level of physical fitness (PF). The link between PF and brain activity is widely accepted but the specificity of cognitive functions affected by physical fitness across the adult lifespan is less understood. The present study aims to clarify whether PF is basically related to cognition and general intelligence in healthy adults, and whether higher levels of PF are associated with better performance in the same or different cognitive functions at different ages.

Methods

A sample of 490 participants (20-70 years) was analyzed to examine this relationship. Later, the sample was split half into the young to middle-aged group (YM; 20-45 years; n = 254), and the middleaged to older group (MO; 46-70 years; n = 236). PF was measured by a quotient of maximum power in a bicycle ergometry test PWC-130 divided by body weight (W/kg), which was supported by a self-reported level of PF. Cognitive performance was evaluated by standardized neuropsychological test batteries.

Results

Regression models showed a relationship between PF and general intelligence (g-factor) and its subcomponents extracted using structural equation modeling (SEM) in the entire sample. This association was moderated by age, which also moderated some specific cognitive domains such as attention, logical reasoning, and interference processing. After splitting the sample into two age groups, a significant relationship was found between cognitive status, as assessed by the Mini Mental State Examination (MMSE), and PF in both age groups. However, apart from cognitive failures in daily life (CFQ), no other association between PF and specific cognitive functions was found in the YM group. In contrast, several positive associations were observed in the MO group, such as with selective attention, verbal memory, working memory, logical reasoning, and interference processing.

Discussion

These findings show that middle-aged to older adults benefit more from PF than younger to middle-aged adults. The results are discussed in terms of the neurobiological mechanisms underlying the cognitive effects of PF across the lifespan.

Clinical trial registration

https://clinicaltrials.gov/ct2/show/NCT05155397, identifier NCT05155397.

Effectiveness of Computerized Cognitive Training by VIRTRAEL on Memory and Executive Function in Older People: A Pilot Study

The prevalence of people over 60 years of age with cognitive impairment has increased in recent decades. As a consequence, numerous computerized cognitive trainings (CCT) have been developed. This pilot study aimed to determine the effectiveness of the CCT with VIRTRAEL in improving older adults' cognition. Fifty-five participants (x¯ = 72.7 years; SD = 6.5) underwent CCT, and twenty participants (x¯ = 76.1 years; SD = 7.6) received face-to-face cognitive stimulation with a paper-and-pencil methodology. Both trainings were conducted in nine sessions (45-60 min each). Participants completed a pre-post training neuropsychological assessment. ANCOVAs and the standardized clinical change were performed. VIRTRAEL's group showed a significant and greater improvement in verbal learning (p < 0.006) and delayed recall (p ≤ 0.001), working memory (p < 0.005), abstract (p < 0.002) and semantic reasoning (p < 0.015), and planning (p < 0.021). Additionally, more large clinical changes (d > 0.8) were found in the VIRTRAEL condition (in verbal learning and delayed free and cued recall) than in the standard group. Here we show that the CCT with VIRTRAEL is effective in improving cognitive function in older adults and is superior to the standard format. These preliminary findings indicate that CCT is a useful tool potentially applicable in the fight against cognitive symptomatology associated with aging and neurodegenerative diseases. VIRTRAEL represents a breakthrough in this field as it is inexpensive and easily accessible to any older person, regardless of whether they live far from health care resources.

Effect of 3D-MOT training on the execution of manual dexterity skills in a population of older adults with mild cognitive impairment and mild dementia

Computerized cognitive training tools are an alternative to preventive treatments related to cognitive impairment and aging. In this study, the transfer of 3D multiple object tracking (3D-MOT) training on manual dexterity concerning fine and gross motor skills in 38 elderly participants, half of them with mild cognitive impairment (MCI) and the other half with mild dementia (MD) was explored. A total of 36 sessions of the 3D-MOT training program were administered to the subjects. The Montreal Cognitive Assessment (MoCA) test was used to assess the baseline cognitive status of the participants. Two batteries of manual motor skills (GPT and MMDT) were applied before and after the 3D-MOT training program. The results showed an interaction effect of training and improvement in manual dexterity tests, from the first training session until the fifteenth session, and after this range of sessions, the interaction effect was lost. However, the training effect continued to the end of the thirty-six-session program. The experimental results show the effect of cognitive training on the improvement of motor skills in older adults. This type of intervention could have a broad impact on the aging population in terms of their attention, executive functions, and therefore, their quality of life.

The Effects of Cognitive Training in Healthy Community Residing Thai Elderly: A Randomized Controlled Trial

Purpose

Cognitive training intervention (CTI) is defined as any mechanism of action of a non-pharmacological procedure provided to improve cognitive function. CTI in healthy elderly has the potential to improve cognitive function; however, the effects of interactive computerized-CTI in old ages have been inconclusive. The present study aimed to determine the effects of low-technology CTI in community-based populations.

Patients and Methods

The study was a 2-arm parallel single-blinded randomized controlled intervention trial. The main outcome measured global cognitive function utilizing the Thai Mental State Examination (TMSE); the minor outcomes were cognitive subdomains and psychosocial outcomes (ie, quality of life and depression). The primary endpoint assessed the treatment effect at the 12th week (T1), while the secondary endpoint evaluated the carry-over effect at the 24th week (T2).

Results

Eighty-six eligible participants were recruited from a senior society on the edge of Bangkok. At baseline (T0), the mean age and TMSE score among CTI (n = 44) and wait-list (n = 42) groups were similar (age; 66.66 ± 5.52 and 67.52 ± 6.46; TMSE; 28.84 ± 1.38 and 28.83 ± 1.12, respectively). For the CTI group, the mean number of cognitive training sessions was 14.82 ± 7.62. By using intention-to-treat analysis at the primary endpoint, the mean difference score of TMSE in the CTI group was significantly higher than the wait-list group (∆TMSE_{between group} at T1-T0 = 0.57; 95% CI = 0.07 to 1.08), while the effect size was 0.48. At the secondary endpoint, there was no significant difference observed between the CTI and wait-list groups (∆TMSE_{between group} at T2-T0 = 0.33; 95% CI = -0.23 to 0.88), while the effect size was 0.25. The cognitive subdomains and psychosocial outcomes were discovered with no significant difference.

Conclusion

CTI showed significant treatment effect for improvement in global cognitive function in healthy Thai elderly but did not demonstrate carry-over effect. This study provided preliminary evidence of the feasibility of implementing low-technology CTI in middle-income countries.

The impact of physical fitness, social life, and cognitive functions on work ability in middle-aged and older adults

Objective

Demographic changes encompass societies to maintain the work ability (WA) of aging workforces. The present study explored the relationship between modifiable lifestyle factors, cognitive functions, and their influence on WA, using a multi-group structural equation approach.

Method

Cross-sectional data from 247 middle-aged and 236 older employees from the Dortmund Vital Study were included in this analysis. We proposed a model with three exogenous variables (Physical Fitness, Cognitive Functions, and Social Life), and with WA as the endogenous variable. WA was measured with the Work Ability Index (WAI), which considers job demands and individual physical and mental resources. Multi-group analyses were based on the principles of invariance testing and conducted using robust estimation methods.

Results

Results revealed that Social Life outside work had significant positive effects on WA in both, middle-aged and older adults. Physical Fitness had a significant effect on WA only in middle-aged adult, and Cognitive Functions had no significant influence on WA in either group. In older adults, Physical Fitness correlated with Cognitive Functions, whereas in middle-aged adults, Cognitive Functions marginally correlated with Social Life.

Conclusions

Our results underline the importance of an active social life outside the workplace for WA, regardless of the employees’ age. The influence of Physical Fitness on WA changes with increasing age, indicating the necessity to have a differentiated view of age effects and interacting influencing factors. Our research contributes to the knowledge of how WA could be most effectively promoted in different age groups.

Clinicaltrials.gov NCT05155397; https://clinicaltrials.gov/ct2/show/NCT05155397.

Age is more than just a number: The relationship among age, non-chronological age factors, self-perceived driving abilities, and autonomous vehicle acceptance

Globally, adults aged 65 and older are a rapidly-growing population. Aging is associated with declines in perceptual, cognitive, and physical abilities, which often creates challenges in completing daily activities, such as driving. Autonomous vehicles (AVs) promise to provide older adults one way to maintain their mobility and independence. However, recent surveys of AV acceptance suggest that older adults have a lower AV acceptance compared to younger generations. One challenge is that most of these assessments have not accounted for the various non-chronological age factors that contribute to how older adults perceive their own driving skills and the utility of AVs. To fill this research gap, this study investigated the effects of non-chronological age factors and rated self-perceived driving abilities on AV acceptance across three age groups. An online survey was conducted using Amazon Mechanical Turk (MTurk), for which 438 valid responses were received. Respondents were categorized into a younger (18-40 years), middle-aged (41-64 years), and older (65-79 years) adult age group. Results showed that drivers of a younger age, with higher educational attainment, who rated themselves to have higher social support, and who have lower rated self-perceived driving abilities, report being more willing to accept AVs. Findings from this work can help to inform models of AV technology acceptance and guide in the development of marketing strategies to promote knowledge of AVs.

Prenatal dance activity enhances foetal and postnatal cognitive and motor development

Introduction

No research has examined the impact of any physical-artistic-cognitive activity on foetal neurodevelopment. The aim of the study was to investigate the efficacy of a unique prenatal dance activity in pre- and postnatal cognitive and motor development as a complementary health care practice.

Methods

26 clinically uncomplicated primiparas and multiparas with singleton pregnancies and their later born children were examined in this prospective study at the University of Pécs, Hungary. The activity group participated in supervised, 60-min, twice-weekly, moderate-intensity prenatal dance classes for 19.56 ± 3.97 weeks, whereas the control group did not. We determined the developmental ages of their children with the Bayley Scales of Infant and Toddler Development in both groups at 5 weeks of age and in the activity group at 33 months of age.

Results

Prenatal dance activity did not cause any adverse outcomes. Infants in the activity group had significantly higher mean developmental ages than the control group regarding cognitive skills (P < 0.001), receptive (P < 0.001) and expressive communication (P = 0.007), fine (P < 0.001) and gross motor (P = 0.001). As toddlers their mean developmental ages were significantly higher than their mean calendar age regarding cognitive skills (P = 0.001), receptive (P = 0.001) and expressive communication (P = 0.001), fine (P = 0.002) and gross motor (P = 0.001).

Conclusions

Our results confirm the safe implementation of this prenatal dance activity and the more advanced cognitive and motor development of children in the activity group as infants compared to the control group and as toddlers compared to the norm. These results offer a novel approach to dance in pre- and postnatal clinical practice.

Association of Playing Cards or Mahjong with Cognitive Function in Chinese Older Adults

Cognitive decline in older adults is a major public health threat. This study aimed to explore the association of participation in cards or mahjong with cognitive function in older adults. A total of 7308 older adults were selected from the 2018 Chinese Longitudinal Healthy Longevity Survey. A modified Mini-Mental State Examination (MMSE) was used to assess cognitive function. The participants were classified according to the frequency of playing cards or mahjong into the “regularly” (R) group, “occasionally” (O) group, or “never” (N) group. The results showed that older persons in the R group and O group had better cognitive function than those in the N group. Specifically, significant differences were found in attention and calculation, language, and total MMSE score between the R group and the N group. However, significant differences were not observed for adults aged 60–69 years old. Regression analysis indicated that playing cards or mahjong, together with age, educational level, sex, marital status, and occupation before age 60 could explain the cognitive function. The findings suggest that there is an association between participation in cards or mahjong and cognitive function in the population of Chinese older adults, and that the frequency of participation plays an important role in the association.

A Literature Review of High-Tech Physiotherapy Interventions in the Elderly with Neurological Disorders

Neurological physiotherapy adopts a problem-based approach for each patient as determined by a thorough evaluation of the patient’s physical and mental well-being. Τhis work aims to provide a literature review of physical therapy interventions in the elderly with neurological diseases (NDs) and discuss physiotherapy procedures and methods that utilize cutting-edge technologies for which clinical studies are available. Hence, the review focuses on acute NDs (stroke), deteriorating NDs (Parkinson’s disease), and age-related cognitive impairment. The most used physiotherapy procedures on which clinical data are available are balance and gait training (robot-assisted or not), occupational therapy, classical physiotherapy, walking and treadmill training, and upper limb robot-assisted therapy. Respectively, the most often-used equipment are types of treadmills, robotic-assisted equipment (Lokomat^® and Gait Trainer GT1), and portable walkway systems (GAITRite^®), along with state-of-the-art technologies of virtual reality, virtual assistants, and smartphones. The findings of this work summarize the core standard tools and procedures, but more importantly, provide a glimpse of the new era in physiotherapy with the utilization of innovative equipment tools for advanced patient monitoring and empowerment.

Effects of a 6-Month Multifaceted Diet and Exercise Intervention on Cognition in Older Adults at Risk of Cognitive Decline: The PONDER Double-Blind, Placebo-Controlled Randomized Trial

Background: Multidomain interventions which incorporate exercise and dietary supplementation to target both cognitive and physical health domains may be an important approach to delay cognitive decline. Objective: The Protein Omega-3 aNd vitamin D Exercise Research (PONDER) study investigated the effects of a 6-month multifaceted intervention in community-dwelling older adults with subjective memory impairment on cognition (primary outcome), physical function, and body composition with a further 6-month follow up for cognition (secondary outcomes). Methods: Single-center, community-based, parallel-group, randomized, double-blind placebo-controlled trial involving a 6-month multifaceted intervention with a further follow-up at 12 months. A total of 147 participants [mean age 70.2 years (SD 6.1), 70% female] were randomized to a multimodal exercise program consisting of twice-weekly supervised resistance and aerobic training, combined with a daily omega-3 (900 mg EPA, 600 mg DHA), vitamin D (1000 IU) and protein (20 g) supplement (n = 73), or a control condition (n = 74) comprising stretching/flexibility sessions combined with a placebo. The primary outcome was a composite CogState measure and Trail-Making Test B-A. Results: There were no significant between-group differences in the change of cognition at 6 or 12 months or physical function outcomes at 6 months, but the intervention significantly improved total lean mass compared to controls [0.72 kg (95% CI 0.26–1.19), p = 0.001]. Conclusion: A multi-faceted intervention including an omega-3, vitamin D and protein-enriched supplement with twice-weekly exercise training did not provide any benefits to cognitive or physical function in older adults with subjective memory impairment, despite improvements in lean mass.

Music experience predicts episodic memory performance in older adult instrumental musicians

OBJECTIVE

Previous research suggests that there is a relationship between music lessons early in life and cognitive functioning in late life. The current study examined 1) how lifestyle factors, including music lessons, physical and social activity, and health predict late life cognition and 2) how unique music training variables (e.g., hours practiced, years in lessons, age of acquisition) predicted cognitive scores for older adults.

METHODS

Participants completed a neuropsychological battery examining major cognitive domains, and completed questionnaires on music experience, physical and social activity, and physician diagnosed health factors.

RESULTS

Results suggested that belonging to the musician group predicted scores on executive functioning, language, and visual spatial ability. Among instrumental musicians, number of years in formal training and current number of hours playing per week predicted scores on verbal memory. Age of acquisition was not a significant predictor of cognitive functioning.

CONCLUSIONS

Music training significantly predicted scores on tests of executive function, visual spatial ability, and language, above and beyond other variables, including current age and health and lifestyle factors. The number of years of formal training predicted scores on verbal learning and memory, with significant implications for aging. The results are discussed in the context of cognitive aging and music education.

Connection between Lifestyle and Life Satisfaction of Older Adults in Relation to the Living Environment

BACKGROUND: Physical activity, healthy diet and avoiding risk factors are essential for a healthy lifestyle of older adults and for their life satisfaction. AIM: The aim of the research was to determine the connection between lifestyle and life satisfaction of older adults in relation to the living environment (home environment, institutional environment). METHODS: The research was based on a non-experimental quantitative research approach. We used the Oldwellactive standardised questionnaire to obtain lifestyle data and the SWLS scale to determine life satisfaction. The study included 656 older adults with an average age of 78.2 years who lived in a domestic (n = 380) and institutional environment (276). RESULTS: Older adults living in the home environment rate their lifestyle higher (AV = 2.38, SD = 0.77) than those in the institutional environment (AV = 2.31, SD = 0.88), the difference is not statistically significant p = 0.304). Eating habits with regard to the location of residence showed statistically significant differences in the consumption of meat, fish and fish products and milk and dairy products (p <0.001). In the institutional environment, older adults are more likely to perform balance-enhancing exercises, while they consume more alcohol in the home environment. By assessing conditional associations, we establish a positive association between life satisfaction and lifestyle (estimated value = 21,600, p = 0,000). Older adults living in the institutional environment are more satisfied with life (v= 23,097) than those living in the home environment (N= 21.774). CONCLUSION: The satisfaction of older adults with their life increases if an individual’s lifestyle improves. Older adults living in the institutional environment are more satisfied with life than those living in the home environment. In the future, it will be necessary to pay more attention to the study of living in a home environment, in accordance with the strategy of long-term care for the older adults.

Study protocol for 'the effects of multimodal training of cognitive and/or physical functions on cognition and physical fitness of older adults: a cluster randomized controlled trial'

Background

The elderly population worldwide is increasing exponentially which will be associated with more people suffering from cognition and fitness declines. The well-established benefits of exercise training for the elderly’s cognitive and physical functioning have been observed. However, the amalgamated effect of combining cognitive and physical exercises on the older adults’ cognitive functions, physical fitness, or psycho-related health remains unclear. Thus, this study protocol was planned to conduct different combinations of cognitive and/or physical training interventions to community-dwelling older adults and expected to see the multifaceted effects of the varied combination of training on their health.

Methods

This study is a cluster randomized controlled trial (CRCT). A total of 285 older adults (age ≥ 60) from twenty elderly centres as clusters will be randomly selected and assigned to intervention groups (IGs, n = 16) or control groups (CGs, n = 4). Each IG will be randomly assigned to one of the four combinations of three training modes that include cognitive (A), physical (B), and combined cognitive and physical training (CCPT, i.e. C), namely Mixed ABC, A + B, C + A, B + C. The intervention will last for 4 months in which the training is conducted for 16 sessions, 2 sessions per week, and 60 min per session. Four repeated assessments (pre-test, two post-training tests after 2 months and 4 months, and a follow-up test) will be conducted. The CG will only receive the four repeated assessments but no intervention. The outcome measures include cognitive tests (tests of execution, memory, and psych-social status), physical fitness, and dynamic balance tests.

Discussion

This study will provide substantial evidence that the integrated format of cognitive and physical exercises training will have higher cognition and fitness impact than the single training modes, and all these mixed modalities will have greater positive outcomes than the control condition. If the effectiveness is proven, the intervention can be further explored and extended to the nation so that many more elderly would be benefited.

Trial registration

The trial has been registered in the ClinicalTrials.gov in U.S. NIH (ID: NCT04727450, date: January 27, 2021).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03031-5.

Effects of exergame and video game training on cognitive and physical function in older adults: A randomized controlled trial

Few studies have simultaneously explored the training effects of exergame and video game. The purpose of this study was to investigate the effects of exergame and video game training on cognitive and physical function in healthy older adults. Eighty-four healthy older adults were randomly assigned to exergame training group, video game training group, and control group. Cognitive and physical function was measured before and after the training. Both training groups improved in verbal memory and aerobic endurance, but the training effects were greater in the exergame training group. The exergame training group also showed significant improvement in lower limb strength and balance. The current study provides evidence that exergame training, incorporating both cognitive engagement and physical activity, exerts greater benefits than cognitively engaging video game training alone. The findings shed lights into the future use of exergame in preventing cognitive and physical function decline in older adults.

The Effects of Combined Cognitive-Physical Interventions on Cognitive Functioning in Healthy Older Adults: A Systematic Review and Multilevel Meta-Analysis

Research has shown that both physical exercise and cognitive training help to maintain cognition in older adults. The question is whether combined training might produce additive effects when the group comparisons are equated in terms of exercise intensity and modality. We conducted a systematic electronic search in MEDLINE, PsycInfo, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify relevant studies published up to February 2021. Seven hundred and eighty-three effect sizes were obtained from 50 published intervention studies, involving 6,164 healthy older adults, and submitted to a three-level meta-analysis. Results showed that combined training produced a small advantage in comparison to single cognitive training on executive functions, whereas both types of training achieved similar effects on attention, memory, language, processing speed, and global cognition. Combined training achieved higher training gains in balance than single physical training, indicating a transfer from cognitive training to balance. Performing cognitive and physical exercise simultaneously, and interactive training (e.g., exergames, square stepping) produced the largest gains in executive functions, speed, and global cognition, as well as the largest improvements in physical functions. Aerobic training was associated with higher effects in attention and fitness, whereas non-aerobic training produced larger effects in global cognition and balance. For all cognitive and physical outcomes, training resulted more advantageous when performed in a social context, even though individual training obtained similar results in balance as group training.

Systematic Review Registration:www.crd.york.ac.uk/prospero/, identifier: CRD42020175632.

The Impact of Exercise and Virtual Reality Executive Function Training on Cognition Among Heavy Drinking Veterans With Traumatic Brain Injury: A Pilot Feasibility Study

Executive function (EF) underlies self-control deficits in alcohol use disorder (AUD) and traumatic brain injury (TBI). Cognitive training is a promising adjunctive treatment targeting TBI- and AUD- related cognitive dysfunction. However, major limitations related to compliance and generalizability in the field of cognitive training exist. Physical activity is associated with enhanced cognitive performance across several executive functions and may enhance the benefits of cognitive training. Virtual reality provides multisensory embodied experiences which are likely to engage brain networks more efficiently than standard cognitive training systems, ultimately resulting in greater near- and far-transfer effects. This pilot study aimed to obtain feasibility data and a preliminary assessment of an enriched virtual reality (VR) EF training (EFT) intervention combined with exercise (NCT03786276). Using an 8-week randomized adaptive design study, 30 AUD treatment seeking U.S. Veterans completed nine sessions of exercise-only (n = 15) or gameplay control (n = 15) over 3 weeks, followed by a week-4 repeat assessment in Phase 1. Twenty-three participants completed and moved onto Phase II, where they completed up to nine sessions of VR-EFT plus exercise and completed a week-8 end-of-study assessment. Primary outcomes included feasibility to retain participants, usability, and satisfaction of using VR-EFT. Secondary and exploratory outcomes included within group assessment of change in cognitive function, alcohol use, alcohol craving, and post-concussive symptoms among the three treatment conditions.VR-EFT was feasible with moderate usability and high acceptability ratings.The most common VR-related adverse effect was motion sickness (n = 2/16, 12.5%). The VR-EFT condition was associated with significant improvement in inhibition-switching and visual scanning (both p < 0.05) during Phase II. Exercise-only was associated with significant improvements in cognitive inhibition, cognitive flexibility, reductions in alcohol craving, and number of standard alcohol drinks per week (all p ≤ 0.05). The gaming-control condition was associated with improvement in cognitive flexibility and visuospatial immediate recall (both p < 0.05) during Phase 1. Recruitment and retention of U.S. veterans with AUD and TBI into an exercise plus VR-EFT intervention is feasible, but technological barriers may impact usability. VR-EFT was associated with improvement in executive function domains that were targeted in as little as 3-week and nine sessions of VR-EFT exposure. Results are promising and indicate the need for a larger controlled investigation to assess the efficacy of VR-EFT to enhance treatment outcomes among AUD treatment-seeking U.S. veterans with co-occurring AUD and TBI.

Clinical Trial Registration

www.ClinicalTrials.gov, Identifier: NCT03786276.

Does regularly playing serious gaming improve cognitive functioning of seniors in care facilities? Controlled Effectiveness Trial on a Representative German Sample

Background

Serious games have been found to have enhancing and preventative effects on cognitive abilities in healthy older adults. Yet, there are few results on the effects in older seniors with age-related low cognitive impairments. Their special needs were considered when designing and using innovate technology in the area of prevention, which is especially relevant owing to the continuously aging population.

Objective

The objective of this study was to evaluate the impact of a serious game on the cognitive abilities of seniors in order to potentially implement innovative resource-oriented technological interventions that can help to meet future challenges.

Methods

In this controlled trial, we tested the serious game MemoreBox, which features modules specifically designed for seniors in nursing homes. Over a period of 1 year, we tested the cognitive abilities of 1000 seniors at 4 time points using the Mini-Mental Status Test. Only half of the participating seniors engaged with the serious game.

Results

The study included an intervention group (n=56) and a control group (did not play; n=55). Based on the in-game data collection, a second intervention group (n=38) was identified within the original intervention group, which exactly followed the planned protocol. There were no noteworthy differences between the demographic and main variables of the overall sample. The large reduction in the sample size was due to the effects of the COVID-19 pandemic (drop-out rate: 88.9%). The CI was set at 5%. Mixed analysis of variance (ANOVA) between the cognitive abilities of the intervention and control groups did not show a statistically significant difference between time and group (F_{2.710,295.379}=1.942; P=.13; partial η²=0.018). We noted approximately the same findings for mixed ANOVA between the cognitive abilities of the second intervention and control groups (F_3,273=2.574; P=.054; partial η²=0.028). However, we did observe clear tendencies and a statistically significant difference between the 2 groups after 9 months of the intervention (t_88.1=−2.394; P=.02).

Conclusions

The results of this study show similarities with the current research situation. Moreover, the data indicate that the intervention can have an effect on the cognitive abilities of seniors, provided that they regularly play the serious game of MemoreBox. The small sample size means that the tendency toward improvement cannot be proven as statistically significant. However, the tendency shown warrants further research. Establishing an effective prevention tool as part of standard care in nursing homes by means of an easy-to-use serious game would be a considerable contribution to the weakened health care system in Germany as it would offer a means of activating senior citizens in partially and fully inpatient care facilities.

Trial Registration

German Clinical Trials Register DRKS00016633; https://tinyurl.com/2e4765nj

Game-based digital therapeutics for children and adolescents: Their therapeutic effects on mental health problems, the sustainability of the therapeutic effects and the transfer of cognitive functions

Mental health problems in childhood and adolescence (e. g., attention deficits, problems in emotional understanding and subclinical levels of anxiety) are reported to develop further in adulthood and/or to increase the risk of developing mental health disorders in adulthood. Although it is important to provide treatment or prevention interventions for children and adolescents in order to reduce the risk of the further development of mental health problems, the pharmacological and behavioral treatments for this age group have limitations (e.g., limited access, unsustainable treatment effects and the lack of engagement in intervention). In order to overcome the limitations of conventional treatments, the use of digital technology, especially video games for this age group, is suggested. In order to be accepted as clinical interventions, objective evidence for the therapeutic effects of digital therapeutic that used video games to treat or prevent targeted mental health problems are required. Thus, this review aims to explore whether game-based digital therapeutics (DTx) for children and adolescents showed therapeutic effects on targeted mental health problems. As game-based DTx are suggested to show sustained therapeutic effects and the transfer of cognitive functions, it also reviews the maintenance of the therapeutic effects of DTx and the extent of the transfer of cognitive functions. Game-based DTx that are developed to treat or prevent mental health problems (e.g., attention deficit, depression) in children and adolescents are found to show therapeutic effects on targeted mental health problems despite the limitations (e.g., small sample size, limited investigation of the sustainability). This review would contribute to the understanding of whether there is objective evidence of the therapeutic effects of digital therapeutics using video games that deliver treatment or prevention interventions for mental health problems in children and adolescents.

The adaptive aging brain

The aging brain is shaped by many structural and functional alterations. Recent cross-disciplinary efforts have uncovered powerful and integrated adaptive mechanisms that promote brain health and prevent functional decline during aging. Here, we review some of the most robust adaptive mechanisms and how they can be engaged to protect, and restore the aging brain.

Dance, aging, and neuroplasticity: an integrative review

This study aimed to summarize investigations that examined the benefits of dance on the neuroplasticity of older healthy adults, report structural and functional changes in the brain, and identify the strategies used in training protocols. The integrative review was perfomed in PubMed, Web of Science and Scopus databases, including randomized clinical trials, quasi-experimental, cross-sectional and cohort studies published in English, between 2010-2020. Twelve articles ware selected. Dance practice was associated with an improvement in functional connectivity, cognitive performance, and incresead brain volumes. Our results main supports studies on the plasticity induced by dance training in healthy older people.

Remote clinical trials: A timely opportunity for a virtual reality approach and its potential application in neurology

The COVID-19 pandemic boosted the expansion and development of new remote models of care and clinical research modalities. Health systems are going to implement telemedical innovations in the near future. Virtual clinical trials (VCT), also known as remote or decentralized ones, may profoundly change the way how clinical studies are conducted, for the benefit of patients with chronic and neurological diseases who are often fragile and may have limited access to traditional healthcare facilities. Despite significant progress, several limitations still need to be addressed to implement telemedicine technologies for VCT. The information and communication technology (ICT) devices (e.g., mobile apps and wearables) may be applied to VCTs but show some practical issues that may hamper the compliance with rigorous research criteria and protocols. We herewith discuss the advantages and disadvantages of virtual reality (VR) in combination with other ICT devices and solutions to improve the conduction of VCT in patients with neurological disorders. The so-called "digital divide," that is, the gap between people who can and those who cannot access high-speed and broadband internet connections, and issues related to VR, such as VR sickness, should be addressed to improve larger VCT participation to neurological patients.

Effects of multi-domain cognitive training on working memory retrieval in older adults: behavioral and ERP evidence from a Chinese community study

Working memory (WM) is a fundamental cognitive function that typically declines with age. Previous studies have shown that targeted WM training has the potential to improve WM performance in older adults. In the present study, we investigated whether a multi-domain cognitive training program that was not designed to specifically target WM could improve the behavioral performance and affect the neural activity during WM retrieval in healthy older adults. We assigned healthy older participants (70-78 years old) from a local community into a training group who completed a 3-month multi-domain cognitive training and a control group who only attended health education lectures during the same period. Behavioral and electroencephalography (EEG) data were recorded from participants while performing an untrained delayed match or non-match to category task and a control task at a pre-training baseline session and a post-training follow-up session. Behaviorally, we found that participants in the training group showed a trend toward greater WM performance gains than participants in the control group. Event-related potential (ERP) results suggest that the task-related modulation of P3 during WM retrieval was significantly enhanced at the follow-up session compared with the baseline session, and importantly, this enhancement of P3 modulation was only significant in the training group. Furthermore, no training-related effects were observed for the P2 or N2 component during WM retrieval. These results suggest that the multi-domain cognitive training program that was not designed to specifically target WM is a promising approach to improve WM performance in older adults, and that training-related gains in performance are likely mediated by an enhanced modulation of P3 which might reflect the process of WM updating.

In aged rats, differences in spatial learning and memory influence the response to late-life Environmental Enrichment

It has clearly been demonstrated that cognitive stimulation, physical exercise, and social engagement help counteract age-related cognitive decline. However, several important issues remain to be addressed. Given the wide differences in cognitive impairment found among individuals of the same age, identifying the subjects who will benefit most from late-life interventions is one such issue. Environmental Enrichment (EE) is a particularly valuable approach to do this. In this study, aged (21-month-old) rats were assigned to a better (BL) or a worse (WL) learner group (training phase) and to a non-impaired (NI) or an impaired (I) group (probe phase) by their performance on the Morris Water Maze, using the test performances of adult (12-month-old) rats as the cut-offs. The aged rats were retested after a 12-week EE or standard housing (SH) protocol. After 12 weeks, the performances of SH rats had deteriorated, whereas all rats benefited from EE, albeit in different ways. In particular, the animals assigned to the BL and the NI groups prior to EE still performed as well as the adult rats (performance preservation) whereas, critically, the animals assigned to the WL and the I groups before EE showed such improved performances that they reached the level of the adult rats (performance improvement), despite having aged further. EE seems to induce the preservation in BLs and the improvement in WLs of spatial search strategies and the preservation in NIs and the increase in Is of a focused and protract research of the escape point. Our findings suggest that late-life EE prevents spatial learning and memory decline in still cognitively preserved animals and stimulates residual functional reserve in already cognitively compromised animals. Future research should focus on individually tailored stimulation protocols to improve their effect and afford a better understanding of the underlying processes.

The Efficacy of a Multicomponent Functional Fitness Program Based on Exergaming on Cognitive Functioning of Healthy Older Adults: A Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Regular physical exercise can attenuate age-related cognitive decline. This study aimed to investigate the effect of a physical exercise multicomponent training based on exergames on cognitive functioning (CF) in older adults.

RESEARCH DESIGN AND METHODS

This randomized controlled trial included older adults aged 61-78. Participants were randomly allocated to an intervention group (IG; n = 15) or active control group (CG; n = 16). The IG was exposed to a combined training with traditional exercise and exergaming, twice a week over a period of 12 weeks. The CG performed only traditional sessions. CF was assessed by the Cognitive Telephone Screening Instrument. The time points for assessment were at zero (pretest), 12 (posttest), and 17 weeks (follow-up).

RESULTS

Active CG and IG increased from pretest to posttest in short-term memory (STM), long-term memory (LTM), and Cognitive Telephone Screening Instrument total score 1.98 > Z < 3.00, ps < .005, with moderately large positive effects (.36 > r < .54). A significant increase was seen from posttest to follow-up in STM, Z = 2.74, p = .006, and LTM, Z = 2.31, p < .021, only in IG. Across the two time periods posttest to follow-up, there were significant interaction effects between program type and time for STM (p = .022, ηp2=.17) and LTM (p = .004, ηp2=.25), demonstrating a more beneficial effect of the exergames intervention compared to the CG. Discussion and Implications: The integration of exergaming in a multicomponent functional fitness exercise might have the potential to maintain and improve CF (in particular, STM and LTM) in older adults.

Multidomain Cognitive Training Transfers to Attentional and Executive Functions in Healthy Older Adults

Healthy aging is associated with deficits in focused and sustained attention and executive functions. However, cognitive training (CT) provides a promising method to counteract these deficits. In the present randomized controlled study, we examined to what extent CT regimes can improve attention, verbal skills, and inhibition capacities. Over a period of 16 weeks, healthy older adults (65 years and older, mean: 70 years) received a trainer-guided multidomain paper-and-pencil and computerized CT. Pre- and post-training, a battery of psychometric tests was applied that measured the critical functions. This study used two control groups: a passive control and an active control group performing a relaxation training. Compared to a passive control group, the CT led to enhanced performance in the attentional endurance test and the interference list of the Stroop test, whereas no benefits in verbal and crystalized tests were found. Similar effects were found on the attentional endurance compared to the active control group. Additionally, word fluency was enhanced after CT, but the improvement in the Stroop test did not reach significance compared to the active control. The contents of CT were dissimilar to the psychometric tests showing far transfer, whereas no transfer to attentional or memory functions in the daily life assessed by the Cognitive Failures Questionnaire was found. This demonstrates specific gains of multidomain CT on cognitive functions not explicitly trained and lack of transfer to daily activities.

Does dance counteract age-related cognitive and brain declines in middle-aged and older adults? A systematic review

BACKGROUND

Dance is a multidomain activity that combines aerobic, coordination and cognitive exercise. This music-associated physical and cognitive exercise is a leisure activity that motivates people, elicits emotions, and avoids boredom, promoting adherence to practice. Continuing physical activity is of paramount importance, since cognitive benefits tend to disappear or even reverse when training ceases.

OBJECTIVE

The question we addressed in this systematic review is what influence dance has on the brain and cognition of healthy middle-aged and older adults.

LITERATURE SURVEY

We systematically reviewed the effects of dance on brain and cognition in older adults using MEDLINE, Psyc-Info, PubMed and Scopus databases.

METHODOLOGY

After screening 1051 studies, thirty-five met the eligibility inclusion criteria. These studies showed that dance improves brain structure and function as well as physical and cognitive functions.

CONCLUSIONS

The protective effect of dance training on cognition in older adults, together with the possibility of adapting intensity and style to suit possible physical limitations makes this activity very suitable for older adults.

Association of Dance-Based Mind-Motor Activities With Falls and Physical Function Among Healthy Older Adults: A Systematic Review and Meta-analysis

IMPORTANCE

Falls increase morbidity and mortality in adults 65 years and older. The role of dance-based mind-motor activities in preventing falls among healthy older adults is not well established.

OBJECTIVE

To assess the effectiveness of dance-based mind-motor activities in preventing falls.

DATA SOURCES

Systematic search included the PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsychINFO, Abstracts in Social Gerontology, AgeLine, AMED, and Scopus databases from database inception to February 18, 2018, using the Medical Subject Headings aged 65 and older, accidental falls, and dancing.

STUDY SELECTION

This systematic review and meta-analysis included 29 randomized clinical trials that evaluated a dance-based mind-motor activity in healthy older adults with regard to fall risk, fall rate, or well-established measures of physical function in the domains of balance, mobility, and strength. The included studies targeted participants without comorbidities associated with higher fall risk. Dance-based mind-motor activities were defined as coordinated upright mind-motor movements that emphasize dynamic balance, structured through music or an inner rhythm (eg, breathing) and distinctive instructions or choreography, and that involve social interaction.

DATA EXTRACTION AND SYNTHESIS

Standardized independent screening, data extraction, and bias assessment were performed. Data were pooled using random-effects models. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline.

MAIN OUTCOMES AND MEASURES

Primary outcomes were risk of falling and rate of falls. For the secondary end points of physical function (balance, mobility, and strength), standardized mean differences (SMDs) were estimated and pooled (Hedges g).

RESULTS

In this systematic review and meta-analysis of 29 randomized clinical trials, dance-based mind-motor activities were significantly associated with reduced (37%) risk of falling (risk ratio, 0.63; 95% CI, 0.49-0.80; 8 trials, 1579 participants) and a significantly reduced (31%) rate of falls (incidence rate ratio, 0.69; 95% CI, 0.53-0.89; 7 trials, 2012 participants). In addition, dance-based mind-motor activities were significantly associated with improved physical function in the domains of balance (standardized mean difference [SMD], 0.62; 95% CI, 0.33-0.90; 15 trials, 1476 participants), mobility (SMD, -0.56; 95% CI, -0.81 to -0.31; 13 trials, 1379 participants), and lower body strength (SMD, 0.57; 95% CI, 0.23-0.91; 13 trials, 1613 participants) but not upper body strength (SMD, 0.18; 95% CI, -0.03 to 0.38; 4 trials, 414 participants).

CONCLUSION AND RELEVANCE

Among healthy older adults, dance-based mind-motor activities were associated with decreased risk of falling and rate of falls and improved balance, mobility, and lower body strength. This type of activity may be useful in preventing falls in this population.

Enhancing Cognitive Performance of Healthy Czech Seniors through Non-Native Language Learning-A Mixed-Methods Pilot Study

The aim of this article is to discuss the effect of learning a non-native language on the enhancement of cognitive performance in healthy native Czech elderly. In addition, special emphasis is put on the qualitative assessment. To do this, 42 Czech cognitively unimpaired seniors were enrolled into the study. These were then divided into an experimental group (i.e., 20 healthy elderly studied English as a non-native language for three months) and a passive control group (22 healthy elderly, who did not undergo any non-native language intervention). The main outcome measures included the Montreal Cognitive Assessment, statistical processing of the data, and a qualitative content analysis. The results indicate that the cognitive performance of the intervention group did not differ from the control group. Therefore, no cognitive enhancement through non-native language learning was achieved. However, the findings of the qualitative analysis show that such non-native language learning with the peers of the same age is especially beneficial for the overall well-being of healthy seniors, especially as far as their social networks are concerned. Furthermore, participant's subjective feelings from their self-reports indicate that foreign language learning also contributes to acquiring new English words and phrases. However, as there are very few empirical studies on this research topic, further research is needed in order to confirm or refute the present research findings on the enhancement of cognitive performance through non-native language learning in healthy seniors.

No panacea? Tai Chi enhances motoric but not executive functioning in a normal aging population

Tai Chi Chuan (TCC) is a promising intervention against age-related decline. Though previous studies have shown benefits in motoric and cognitive domains, it is unclear how these effects are functionally related. Therefore, a randomized controlled trial was conducted in an aging population (53-85). Two measures of motor functioning - motor speed and functional balance - and three cognitive control measures - shifting, updating and inhibition - were included. The TCC condition consisted of an online 10 week 20 lessons video program of increasing level and control condition of educational videos of similar length and frequency. All analyses were done with Bayesian statistics. Counter to expectation no differences were found in cognition between TCC and control pre-to-posttest. However, there was extreme evidence for TCC benefits on functional balance and moderate evidence for increased motoric speed. After weighing the evidence and limitations of the intervention we conclude that TCC does not enhance cognitive control.

Repetitive Transcranial Magnetic Stimulation Improved Source Memory and Modulated Recollection-Based Retrieval in Healthy Older Adults

Source memory is one of the cognitive abilities that are most vulnerable to aging. Luckily, the brain plasticity could be modulated to counteract the decline. The repetitive transcranial magnetic stimulation (rTMS), a relatively non-invasive neuro-modulatory technique, could directly modulate neural excitability in the targeted cortical areas. Here, we are interested in whether the application of rTMS could enhance the source memory performance in healthy older adults. In addition, event-related potentials (ERPs) were employed to explore the specific retrieval process that rTMS could affect. Subjects were randomly assigned to either the rTMS group or the sham group. The rTMS group received 10 sessions (20 min per session) of 10 Hz rTMS applying on the right dorsolateral prefrontal cortex (i.e., F4 site), and the sham group received 10 sessions of sham stimulation. Both groups performed source memory tests before and after the intervention while the electroencephalogram (EEG) was recorded during the retrieval process. Behavioral results showed that the source memory performance was significantly improved after rTMS compared with the sham stimulation; ERPs results showed that during the retrieval phase, the left parietal old/new effect, which reflected the process of recollection common to both young and old adults, increased in the rTMS group compared with the sham stimulation group, whereas the late reversed old/new effect specific to the source retrieval of older adults showed similar attenuation after intervention in both groups. The present results suggested that rTMS could be an effective intervention to improve source memory performance in healthy older adults and that it selectively facilitated the youth-like recollection process during retrieval. This study was registered in the Chinese Clinical Trial Registry (ChiCTR) with the identifier chictr-ire-15006371.

Effects of multidomain versus single-domain training on executive control and memory in older adults: study protocol for a randomized controlled trial

BACKGROUND

Previous research suggests that both cognitive training and physical exercise help to maintain brain health and cognitive functions that decline with age. Some studies indicate that combined interventions may produce larger effects than each intervention alone. The aim of this study is to investigate the effects of combined cognitive and physical training compared to cognitive training and physical training alone on executive control and memory functions in healthy older adults.

OBJECTIVES

The main objectives of this four-arm randomized controlled trial (RCT) are: to investigate the synergetic effects of a simultaneous, group-based multidomain training program that combines cognitive video-game training with physical exercise, in comparison to those produced by cognitive training combined with physical control activity, physical training combined with cognitive control activity, or a combination of both control activities; to investigate whether event-related potential latencies of the P2 component are shorter and N2 and P3b components assessed in a memory-based task switching task are enhanced after training; and to find out whether possible enhancements persist after a 3-month period without training.

METHODS

In this randomized, single-blind, controlled trial, 144 participants will be randomly assigned to one of the four combinations of cognitive training and physical exercise. The cognitive component will be either video-game training (cognitive intervention, CI) or video games not specifically designed to train cognition (cognitive control, CC). The physical exercise component will either emphasize endurance, strength, and music-movement coordination (exercise intervention, EI) or stretching, toning, and relaxation (exercise control, EC).

DISCUSSION

This RCT will investigate the short and long-term effects of multidomain training, compared to cognitive training and physical training alone, on executive control and memory functions in healthy older adults, in comparison with the performance of an active control group.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03823183. Registered on 21 January 2019.

Effects of Cognitive Rehabilitation on Cognition, Apathy, Quality of Life, and Subjective Complaints in the Elderly: A Randomized Controlled Trial

OBJECTIVE

To determine the efficacy of a new-generation integrative cognitive rehabilitation (CR) program (Rehacop) on cognition, clinical symptoms, quality of life (QoL), and subjective complaints in the elderly.

DESIGN

A randomized controlled trial study with a cohort of elderly people over 55 years of age.

SETTING

Communities of the Basque Country (Spain).

PARTICIPANTS

A total of 124 elderly participants (aged 79.00 ± 8.85 years) were randomized in the Rehacop group (RG) (n = 62) and control group (CG) (n = 62).

INTERVENTION

The RG attended 39 CR sessions for 3 months (3 sessions/week, 60-minute/session) with the Rehacop program. The CG performed occupational tasks with the same frequency and duration as the RG.

METHODS

Participants underwent a neuropsychological assessment at baseline and post-treatment which included cognitive, clinical, and functional tests. In addition, participants and their formal caregivers completed a subjective complaints questionnaire. The data were analyzed according to the intention to treat analysis and with participants who completed the study. This study was registered at clinicaltrials.gov (NCT03435029).

RESULTS

The RG showed significant improvements compared to the CG in neurocognition (ANCOVA timexgroup interaction effect size (η_p²)=0.05, 90% confidence interval (CI) = 0.00-0.12). The RG also reduced apathy (η_p²=0.06, 90% CI = 0.01-0.15) and participants' subjective complaints (η_p²=0.11, 90% CI = 0.03-0.21) and improved QoL (η_p²=0.08, 90% CI = 0.01-0.17).

CONCLUSIONS

Participants who attended the intervention improved their cognition, QoL, and reduced apathy and subjective complaints after treatment. These findings provide a new understanding of the benefits of CR in the elderly.

Current Research on the Impact of Foreign Language Learning Among Healthy Seniors on Their Cognitive Functions From a Positive Psychology Perspective-A Systematic Review

The purpose of this review study is to explore the existing research focusing on the impact of foreign language learning among healthy seniors on their cognitive functions from the positive psychology perspective. The methods are based on a literature review of available sources found on the research topic in two acknowledged databases: Web of Science and Scopus. The search period was not limited by any time period since there are not many studies on this topic. Altogether seven original studies were detected. The findings of this review study thus reveal that foreign language learning (FLL) has a positive impact on the maintenance and/or enhancement of cognitive abilities irrespective of age. In addition, the FLL courses seem to offer new opportunities for healthy seniors in the area of socializing and integration into society, which consequently may positively affect their overall well-being. Furthermore, the research shows that it is partly through the stimulation of social well-being that the cognitive effects of FLL might be observed. Cognitive aspects of older age are to be further investigated, including the importance of learning a foreign language, as basically all research conducted proves at least some maintenance or even improvement of cognitive functions of older people when starting intensive language training.

Structured Cognitive Training Yields Best Results in Healthy Older Adults, and Their ApoE4 State and Baseline Cognitive Level Predict Training Benefits

BACKGROUND

Cognitive training has been shown to improve cognitive functions in healthy older adults. However, little is known about which specific variables are responsible for the improvement.

OBJECTIVE

Our aim was to evaluate whether healthy older adults benefit more from a structured cognitive training program than an unstructured brain jogging program and to identify possible predictors for training success, including apolipoprotein E4 (apoE4).

METHODS

In a randomized controlled trial, participants completed either a 6-week structured cognitive training program (n=35) or a 6-week unstructured brain jogging program (n=35). A control group received no training and was not part of the randomization procedure (n=35). Overall, 105 participants were included in the training data analyses, focusing on verbal memory, attention, and executive functions. Data from an additional 45 previously trained, healthy older adults were used for the predictor analysis.

RESULTS

A significant Time×Training interaction in favor of the structured cognitive training program was found in verbal memory. Low baseline performance on neuropsychological tests was a significant predictor for benefits in verbal memory, attention, and executive functions. A subgroup analysis (n=35) revealed that only noncarriers of the apoE4 allele showed significant gains in long-term verbal memory and attention.

CONCLUSIONS

Our results support the greater effectiveness of structured cognitive training on verbal memory compared with brain jogging and no training. The success of this type of training program may be predicted by sociodemographic, cognitive, and genetic variables.

Short-term computerized cognitive training does not improve cognition compared to an active control in non-demented adults aged 80 years and above

BACKGROUND

Older adults, especially those above age 80, are the fastest growing segment of the population in the United States and at risk for age-related cognitive decline and dementia. There is growing evidence that cognitive activity and training may allow adults to maintain or improve cognitive functioning, but little is known about the potential benefit in the oldest old. In this randomized trial, the effectiveness of a computerized cognitive training program (CCT program) was compared to an active control games program to improve cognition in cognitively normal individuals aged 80 and older.

METHODS

Sixty-nine older adults were randomized to a 24-session CCT program (n = 39) or an active control program (n = 30). Participants completed a pre- and post- training neuropsychological assessment. The primary outcome measure was a global cognitive composite, and the secondary outcomes were the scores on specific cognitive domains (of memory, executive function/attention, and language).

RESULTS

Using linear mixed models, there were no significant differences between the CCT and the active control program on the primary (p = 0.662) or any of the secondary outcomes (language functioning, p = .628; attention/executive functioning, p = .428; memory, p = .749).

CONCLUSION

This study suggests that short-term CCT had no specific benefit for cognitive functioning in non-demented individuals aged 80 and older.

The age-performance relationship in the general population and strategies to delay age related decline in performance

The age-performance relationship describes changes in the organism's structural and functional capabilities over the course of the lifespan. The typical, empirical pattern is an asymmetrical inverted-U shape association with peak capacity occurring early in life. This process is well described in the literature, with an increasing interest in features that characterize this pattern, such as the rate of growth, age of peak performance, and rate of decline with aging. This is usually examined in cohorts of individuals followed over time with repeat assessments of physical or cognitive abilities. This framework ought to be integrated into public health programs, embedding the beneficial (such as physical or cognitive training) or adverse effects (such as chronic diseases or injuries) that respectively sustain or limit capabilities. The maintenance of physical or cognitive performances at older ages would result in both optimal health and promote resistance to disabling conditions and chronic diseases, such as obesity and type 2 diabetes. The causes of accelerated degeneration of health optima are mainly: sedentary and unhealthy lifestyles -including poor nutrition-, exposure to environmental pollutants, and heterogeneity in aging. Better knowledge of optima, compatible with or required for good health, should also allow for establishing ideal conditions for longevity.

Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes

Age-related hearing loss (ARHL) or presbycusis, as the third leading cause of chronic disability in older adults, has been shown to be associated with predisposing cognitive impairment and dementia. Tinnitus is also a chronic auditory disorder demonstrating a growth rate with increasing age. Recent evidence stands for the link between bothersome tinnitus and impairments in various aspects of cognitive function. Both ARHL and age-related tinnitus affect mental health and contribute to developing anxiety, stress, and depression. The present review is a comprehensive multidisciplinary study on diverse interactions among ARHL, tinnitus, and cognitive decline in older adults. This review incorporates the latest evidence in prevalence and risk factors of ARHL and tinnitus, the neural substrates of tinnitus-related cognitive impairments, hypothesized mechanisms concerning the association between ARHL and increased risk of dementia, hearing amplification outcomes in cases with ARHL and cognitive decline, and preliminary findings on the link between ARHL and cognitive impairment in animal studies. Given extensive evidence that demonstrates advantages of using auditory amplification in the alleviation of hearing handicap, depression, and tinnitus, and the improvement of cognition, social communication, and quality of life, regular hearing screening programs for identification and management of midlife hearing loss and tinnitus is strongly recommended.

Impact of Learning a Foreign Language on the Enhancement of Cognitive Functions Among Healthy Older Population

The purpose of this article is to discuss to what extent foreign language learning may enhance cognitive functions among healthy older population. The methods used in this study included cognitive assessments using standardized tests, intervention through English language teaching and learning, and statistical analysis. Out of 60 older Czech citizens, 42 cognitively unimpaired participants were selected for the experiment. These participants were randomly divided into an experimental group (20 subjects) studying English for 12 weeks (three 45-min lessons per week) and a control group (22 subjects) whose members did not have any language training. The results of the research show that there has been a slight enhancement of cognitive skills in the experimental group. Nevertheless, on the whole, the scores of the experimental and control groups did not considerably differ. Despite this fact, the results indicate that cognitive functions among healthy older population can be maintained through regular foreign language training.

Episodic memory boosting in older adults: exploring the association of encoding strategies and physical activity

Background: Contextual memory is susceptible to the effects of aging and its impairment compromises episodic memories and quality of life in older adults. Objective: Compare the effects of cognitive support on incidental contextual memory free recall and recognition with a naturalistic experimental paradigm and explore the association of encoding strategies and physical activity on memory improvement. Methods: Subjects (≥60 years, n = 52) were assigned to one of two encoding conditions for the contextual memory task: with or without an incidental associative instruction to encourage association of an item to its spatial context. Immediate free recall and recognition tests were run to assess the encoding instruction efficiency. The association of memory performance and physical activity was analyzed using the scores on the International Physical Activity Questionnaire (IPAQ) to subdivide each experimental group into Low IPAQ (below median) and High IPAQ (above median) subgroups. Results: The associative encoding instruction increased contextual memory free recall and recognition, with greater effects on free recall. The most robust associations between physical activity and contextual memory were also seen on free recall, in which higher levels of physical activity corresponded to increased baseline performance (non-associative encoding condition) and greater improvement of memory by the encoding support (associative encoding condition). Conclusion: Cognitive support at encoding can improve contextual memory free recall and recognition, suggesting they are prone to rehabilitation. Moreover, higher physical activity levels were positively associated with encoding strategies on contextual memory improvement, increasing the availability of latent process-based components of the cognitive reserve.