Does strategic memory training improve the working memory performance of younger and older adults?

Classification Of MeMory InTerventions: Rationale and developmental process of the COMMIT tool

ABSTRACTOver the last decades, numerous memory interventions have been developed to mitigate memory decline in normal ageing. However, there is a large variability in the success of memory interventions, and it remains poorly understood which memory intervention programs are most effective and for whom. This is partially explained by the heterogeneity of memory intervention protocols across studies as well as often poor reporting of the study design. To facilitate a reporting framework that enables researchers to systemize the content and design of memory intervention paradigms, we developed the Classification Of MeMory InTerventions (COMMIT) tool using a 3-stage developmental process. Briefly, COMMIT was based on qualitative content analysis of already existing memory intervention studies published between April 1983 and July 2020, and iteratively validated by both internal and external expert panels. COMMIT provides an easily-applicable interactive tool that enables systematic description of memory intervention studies, together with instructions on how to use this classification tool. Our main goal is to provide a tool that enables the reporting and classification of memory interventions in a transparent, comprehensible, and complete manner, to ensure a better comparability between memory interventions, and, to ultimately contribute to the question which memory intervention shows the greatest benefits.

Spontaneous memory strategies in a videogame simulating everyday memory tasks

People can use different internal strategies to manage their daily tasks, but systematic research on these strategies and their significance for actual performance is still quite sparse. Here we examined self-reported internal strategy use with a 10-block version of the videogame EPELI (Executive Performance in Everyday LIving) in a group of 202 neurotypical adults of 18-50 years of age. In the game, participants perform lists of everyday tasks from memory while navigating in a virtual apartment. Open-ended strategy reports were collected after each EPELI task block, and for comparison also after an EPELI Instruction Recall task and a Word List Learning task assessing episodic memory. On average, 45% of the participants reported using some strategy in EPELI, the most common types being grouping (e.g., performing the tasks room by room), utilising a familiar action schema, and condensing information (e.g., memorising only keywords). Our pre-registered hypothesis on the beneficial effect of self-initiated strategy use gained support, as strategy users showed better performance on EPELI as compared with no strategy users. One of the strategies, grouping, was identified as a clearly effective strategy type. Block-by-block transitions suggested gradual stabilisation of strategy use over the 10 EPELI blocks. The proneness to use strategies showed a weak but reliable association between EPELI and Word List Learning. Overall, the present results highlight the importance of internal strategy use for understanding individual differences in memory performance, as well as the potential benefit for internal strategy employment when faced with everyday memory tasks.

Self-reported strategy use in working memory tasks

Mnemonic strategies can facilitate working memory performance, but our knowledge on strategy use as a function of task characteristics remains limited. We examined self-reported strategy use in several working memory tasks with pretest data from two large-scale online training experiments. A three-level measure of strategy sophistication (no strategy, maintenance, manipulation) was coded based on participants' open-ended strategy reports. A considerable portion of participants reported some memory strategy, and strategy sophistication was associated with objective task performance. We found a consistent effect of stimulus type: verbal stimuli (letters or digits) elicited higher strategy sophistication than nonverbal ones (colours or spatial positions). In contrast, the association between task paradigm and strategy sophistication was less consistent in the two experiments. The present results highlight the importance of self-generated strategies in understanding individual differences in working memory performance and the role of stimulus characteristics as one of the task-related determinants of strategy use.

Strategy use and its evolvement in word list learning: a replication study

Spontaneous strategy employment is important for memory performance, but systematic research on strategy use and within-task evolvement is limited. This online study aimed to replicate three main findings by Waris and colleagues in Quarterly Journal of Experimental Psychology (2021): in word-list learning, spontaneous strategy use (1) predicts better task performance, (2) stabilizes along the task, and (3) increases during the first two task blocks. We administered a shortened version of their original real-word list-learning task to 209 neurotypical adults. Their first finding was partly replicated: manipulation strategies (grouping, visualization, association, narrative, other strategy) but not maintenance strategies (rehearsal/repetition, selective focus) were associated with superior word recall. The second finding on the decrease in strategy changers over task blocks was replicated. The third finding turned out to be misguided: neither our nor the original study showed task-initial increase in strategy use in the real-word learning condition. Our results confirm the important role of spontaneous strategies in understanding memory performance and the existence of task-initial dynamics in strategy employment. They support the general conclusions by Waris and colleagues: task demands can trigger strategy use even in a familiar task like learning a list of common words, and evolution of strategy use during a memory task reflects cognitive skill learning.

Chanwuyi Lifestyle Medicine Program Improves Memory and Executive Functions of Older Adults With Mild Cognitive Impairment

The Chanwuyi Lifestyle Medicine Program (CLMP) was found to enhance the memory and executive functions of older adults with or without subjective memory complaints. The present study investigated whether similar beneficial effects can be extended to mild cognitive impairment (MCI). Twenty-four older adults with MCI were randomly assigned to receive the CLMP (the experimental group) or strategic memory training (SMT; the active control group) for 10 weeks. They were assessed by neuropsychological tests at baseline and post-intervention. Older adults showed similar visual and verbal memory improvements after receiving the CLMP and SMT. Yet, only those who received the CLMP showed distinct improvements in planning/organization, working memory, and attention in terms of accuracy, with greater cognitive gains associated with older age and lower levels of education and baseline cognitive functions. This study provides preliminary evidence for the effects of the CLMP on improving memory, attention, and executive functions in MCI.

Effects of Strategy-Based Memory Training for Older Adults: Do Booster Sessions Prompt Long-Term Benefits?

This study examined the efficacy of a strategy-based memory training for older adults at short- and long-term with two (5- and 11 months) follow-ups. We also explored whether booster sessions (additional training before the first follow-up) facilitated the maintenance of benefits. Thirty-three older adults received a training based on the teaching of different effective memory strategies. One group completed three booster sessions before the 5 months follow-up. Training gains were examined using a word-list and a face-surname association recall tasks, and transfer effects with a grocery-word list (GL) recall task, a working memory (WM) measure, and a perceived memory functioning questionnaire. Training gains and transfer effects to the WM measure emerged and were maintained up to the second follow-up. No benefits for the GL and perceived memory functioning were found. The "boosted" group had only a slight advantage-in one of the transfer tasks-as shown by effect sizes. This pilot study confirms the efficacy of strategy-based memory training in supporting older adults' memory performance up to 11 months since training completion. However, booster sessions seem not to make a clear difference in prompting long-lasting benefits. Training features capable of fostering generalized, prolonged effects are worth investigating.

Cognitive and hippocampal changes weeks and years after memory training

While immediate effects of memory-training are widely reported in young and older adults, less is known regarding training-dependent hippocampal plasticity across multiple intervention phases, and long-term maintenance of such. Here, 157 healthy young and older adults underwent a training-intervention including two 10 weeks periods of episodic-memory training, separated by two 2 weeks periods of no training. Both age groups showed improvements on a criterion task, which prevailed after 3 years. When compared to the reference condition of no training, relative increases in hippocampal volume were observed after the training across age groups, which were maintained after 10 weeks periods of no training. However, there was age-group dependent temporal variation with respect to timing of effects. Hippocampal volume of the training group did not differ from that of a passive control-group 3 years after the intervention. The young showed an immediate near-transfer effect on a word-association task. We show that training-gains on memory performance can prevail for at least 3 years. Memory training can induce increases in hippocampal volume immediately after the intervention and after months. Episodic-memory training can produce transfer effects to a non-trained memory task in young adults. However, maintained effects on hippocampal volume beyond 10 weeks are uncertain, and likely require continuous training.

Mental-Imagery-Based Mnemonic Training: A New Kind of Cognitive Training

We investigated the immediate and maintenance effects of mental-imagery-based mnemonic training on improving youths’ working memory, long-term memory, arithmetic and spatial abilities, and fluid intelligence. In Experiment 1, 26 Chinese participants (15 boys, 11 girls) aged 10–16 years were divided into an experimental group that received 8 days of mental-imagery-based mnemonic training and a no-contact control group. Participants completed pre-, post-, and three follow-up tests (3, 6, and 12 months after the pre-test). In Experiment 2, 54 Chinese children (28 boys, 26 girls), all 12 years old, were divided into experimental and control groups. Participants completed pre-, post-, and follow-up tests (three months after the pre-test). Results showed that the training significantly affected long-term memory-related task performance but no effects were observed on working memory, arithmetic or spatial ability, or fluid intelligence-related tasks. Moreover, the effect of the training on long-term memory lasted up to one year; the more frequently the training was used, the more effective it was. A content analysis of the feedback submitted by parents of participants in Experiment 2 three months after the training showed that the children used the strategy more for memorizing content such as Chinese and English, as well as for musical scores. Furthermore, there was also the possibility that the training improved abilities and academic performance such as concentration and math performance. Our results provide a basis for the further exploration of mental-imagery-based mnemonic training as a novel training modality.

Memory Training as a Method for Reducing the Misinformation Effect

The two experiments presented in this study investigate the impact of memory training on the misinformation effect. This effect is particularly important in the forensic context as exposing a witness to misinformation may adversely affect the content of their testimony. During the training, the participants were acquainted with seven (Experiment 1) or six (Experiment 2) types of memory errors. It was expected that knowledge of the unreliability of human memory would reduce the misinformation effect and therefore improve the quality of testimony. These hypotheses were confirmed in both experiments. The efficacy of both the complete and reduced training courses was not statistically different. Additionally, in Experiment 1 the effectiveness of warning against misinformation was replicated: respondents warned about misinformation were more resistant to it than those not warned. The tainted truth effect was also present: people warned against non-existent misinformation had lower correctness in the memory test than non-warned ones. Finally, immediate recall of the content of the original information had no impact on the misinformation effect.

Supporting route learning in older adults: the role of imagery strategy

OBJECTIVES

Route learning is an everyday spatial ability important to individuals' independent living, and is known to decline with age. This study aimed to investigate the benefit of using an imagery strategy to support route learning in young and older adults.

METHODS

Forty young adults and 40 older adults learned a path from a video. Twenty of each age group were taught to use an imagery strategy (strategy groups [SGs]), while the others received no specific instructions (control groups [CGs]). Then participants were asked to recall the order and location of landmarks they had seen along the path (landmark ordering and locating tasks).

RESULTS

Young adults recalled the order and location of landmarks better than older adults, and the SGs outperformed the CGs regardless of age. The Age group x Learning group interaction was only significant for the landmark locating task, with the young CG performing better than the older CG, while the older SG proved as good at recalling landmark locations as the young SG. Further, it was only among the older adults that the SG outperformed the CG.

CONCLUSION

These findings newly suggest that using imagery helps to sustain older adults' route learning ability, especially in spatial recall tasks demanding the active manipulation of spatial information learnt, such as locating landmarks previously encountered while navigating a path. These results are discussed within the aging and spatial cognition frameworks.

Mental imagery training in older adults: Which are benefits and individual predictors?

OBJECTIVES

Strategic memory training involves explicit instructions in mnemonic methods to improve recall. Mental imagery is considered among the most effective encoding strategies. The aim of the present study was to assess the benefits of a strategic memory training based on mental imagery (originally proposed by Carretti et al., 2007) and to further investigate its potentials. The study represents a replication in a new and independent cultural setting and features valuable methodological amendments, while it also examines individual predictors of training efficacy.

DESIGN

A sample of 91 older volunteers (age 61-88), divided in training and control group, participated in the training. Specific training gain in the immediate word list recall (criterion task), as well as transfer effects on Letter-Number Sequencing (working memory [WM] task), long-term recall and recognition (LTM tasks) were tested at the pretest and at the posttest.

RESULTS

Analysis of variance showed posttraining effects in immediate word recall and long-term verbal recall, but no effects in WM task and long-term recognition. Regression analysis showed age to be the only significant predictor in one task, the immediate word recall.

CONCLUSIONS

Overall, proposed training can improve some aspects of memory performance by aiding in strategic use of mental imagery. Transfer to other tasks and contribution of individual predictors to training efficacy results limited, however. It seems that training benefits are evident when task similarity enables transfer-appropriate processing (as evidenced in gains of both recall tasks), while training efficacy relies on individual characteristics which contribute to the execution of some task components.

Effects of a Coordinative Ability Training Program on Adolescents' Cognitive Functioning

The purpose of this randomized controlled study was to investigate the effects of a 12-week coordinative ability training program on adolescents’ cognitive functioning, using evaluation tests of visuospatial perception, attention, and working memory. We randomly assigned 60 public school students (14–15 years) to either an experimental coordinative abilities training (∼40 min twice/week) group (n = 30) or a control group (n = 30) who received general psycho-physical wellness training (∼40 min., twice a week). At baseline and after training we used two standardized motor tests and a single cognitive measure (Corsi’s Block-tapping test) to assess students’ visuospatial perception, attention, and working memory. We found a significant Time x Group interaction for the Throwing and Catching Test and Corsi’s Block-Tapping test, reflecting a meaningful experimental group improvement (p < 0.001), and there were no significant pre-post changes found in the control group. Thus, a 12-week program of coordinative abilities was able to improve not only coordination skills but aspects of cognitive functioning relevant to academic achievement.

Spontaneous strategy use during a working memory updating task

Cognitive skill learning postulates strategy generation and implementation when people learn to perform new tasks. Here we followed self-reported strategy use and objective performance in a working memory (WM) updating task to reveal strategy development that should take place when faced with this novel task. In two pre-registered online experiments with healthy adults, we examined short-term strategy acquisition in a ca 20-30-minute adaptive n-back WM task with 15 task blocks by collecting participants' strategy reports after each block. Experiment 1 showed that (a) about half of the participants reported using a strategy already during the very first task block, (b) changes in selected strategy were most common during the initial task blocks, and (c) more elaborated strategy descriptions predicted better task performance. Experiment 2 mostly replicated these findings, and it additionally showed that compared to open-ended questions, the use of repeated list-based strategy queries influenced subsequent strategy use and task performance, and also indicated higher rates of strategy implementation and strategy change during the task. Strategy use was also a significant predictor of n-back performance, albeit some of the variance it explained was shared with verbal productivity that was measured with a picture description task. The present results concur with the cognitive skill learning perspective and highlight the dynamics of carrying out a demanding cognitive task.

Feasibility and Engagement of Multi-domain Cognitive Training in Community-Dwelling Healthy Elderly in Shanghai

BACKGROUND

In recent years, cognitive training has been one of the important non-pharmaceutical treatment methods that could delay cognitive decline and improve quality of life in the elderly. In different types of cognitive training, both the cognitive domains focused on and their training methods widely vary. This study aimed to explore the feasibility and engagement of multidomain cognitive training in Chinese community-dwelling healthy elderly.

METHODS

Based on the cluster sampling method, a total of 151 healthy elderly, aged 70 or above, who lived in the neighborhoods in Shanghai met the inclusion criteria and agreed to participate in the study. Among them, 90 participants were assigned to the cognitive training group (intervention group), and 61 were assigned to the no cognitive training group (control group). Participants in the intervention group attended a 1-h multidomain cognitive training course twice a week for 12 weeks (total of 24 times), which targeted memory, reasoning, strategy-based problem-solving skills, etc. The control group did not receive any intervention.

RESULTS

There was a significant increase in test scores of story recall (t = -8.61, p = 0.00) and Raven's Standard Progressive Matrices (RSPM) (t = -10.60, p = 0.00) after in-class interventions. The overall completion of homework was 77.78%. Fifty percent of the 90 participants completed self-training. The top three self-training methods were physical exercise, reading books and newspapers, and watching TV. The overall attendance rate of the intervention group was 76.14%, and more than 50% of them had an attendance rate of 77.8%. The attendance rate was positively correlated with years of education and baseline SF-36 (physical functioning, general health, vitality, and mental health) scores, whereas it was negatively correlated with baseline disease index and fatalism of personality indicators (p < 0.05).

CONCLUSION

The elderly with higher educational levels and better physical and psychological conditions had a higher engagement in multidomain cognitive training. The training course proved to be rational, feasible, and effective for community-scale application.

A Systematic Review on Predictors of Working Memory Training Responsiveness in Healthy Older Adults: Methodological Challenges and Future Directions

Background: Research on predictors of working memory training responsiveness, which could help tailor cognitive interventions individually, is a timely topic in healthy aging. However, the findings are highly heterogeneous, reporting partly conflicting results following a broad spectrum of methodological approaches to answer the question “who benefits most” from working memory training.

Objective: The present systematic review aimed to systematically investigate prognostic factors and models for working memory training responsiveness in healthy older adults.

Method: Four online databases were searched up to October 2019 (MEDLINE Ovid, Web of Science, CENTRAL, and PsycINFO). The inclusion criteria for full texts were publication in a peer-reviewed journal in English/German, inclusion of healthy older individuals aged ≥55 years without any neurological and/or psychiatric diseases including cognitive impairment, and the investigation of prognostic factors and/or models for training responsiveness after targeted working memory training in terms of direct training effects, near-transfer effects to verbal and visuospatial working memory as well as far-transfer effects to other cognitive domains and behavioral variables. The study design was not limited to randomized controlled trials.

Results: A total of 16 studies including n = 675 healthy older individuals with a mean age of 63.0–86.8 years were included in this review. Within these studies, five prognostic model approaches and 18 factor finding approaches were reported. Risk of bias was assessed using the Quality in Prognosis Studies checklist, indicating that important information, especially regarding the domains study attrition, study confounding, and statistical analysis and reporting, was lacking throughout many of the investigated studies. Age, education, intelligence, and baseline performance in working memory or other cognitive domains were frequently investigated predictors across studies.

Conclusions: Given the methodological shortcomings of the included studies, no clear conclusions can be drawn, and emerging patterns of prognostic effects will have to survive sound methodological replication in future attempts to promote precision medicine approaches in the context of working memory training. Methodological considerations are discussed, and our findings are embedded to the cognitive aging literature, considering, for example, the cognitive reserve framework and the compensation vs. magnification account. The need for personalized cognitive prevention and intervention methods to counteract cognitive decline in the aging population is high and the potential enormous.

Registration: PROSPERO, ID CRD42019142750.

Effects of working memory intervention on language production by individuals with dementia

The purpose of this study was to investigate the effects of working memory intervention on language production by people with mild or moderate Alzheimer's disease (AD). A total of 39 AD patients, 21 with mild AD and 18 with moderate AD and 18 normal controls were given 18 sessions of working memory intervention. After these sessions, the transfer effects and maintenance effects at the 3-month follow-up were assessed. A word-span task and a digit-span task were used to evaluate working memory. Language-production abilities were compared through four tasks: a verbal fluency, a confrontation naming, a word definition, and a picture-description task. Task performances of working memory and language production were the lowest in the baseline stage and the highest in the transfer-effect stage. The three groups had transfer effects in all tasks, while the maintenance effects were limited by groups and tasks. This study proves that working memory intervention for AD patients is effective for language production. In addition, we have paved the way for working memory intervention to improve language production by AD patients in clinical settings by presenting the transfer and maintenance effect for each task of language production.

Risk- and protective factors for memory plasticity in aging

Risk and protective factors for cognitive function in aging may affect how much individuals benefit from their environment or life experiences by preserving or improving cognitive abilities. We investigated the relations between such factors and outcome from episodic-memory training in 136 healthy young and older adults. Tested risk factors included carrying the ɛ4 variant of the apolipoprotein E allele (APOE), age, body mass index, blood pressure, and cholesterol. Protective factors included higher levels of education, intelligence quotient (IQ), physical activity, fatty acids, and vitamin D. Average increases in memory performance were seen after training, with ample variation between individuals. Being young, female, and having higher IQ were positive predictors of memory improvement. No other relationships were observed. Similar benefit was observed across APOE allelic variation. This indicates that beyond IQ, age, and sex, known risk -and protective factors of cognitive function in aging were not significantly related to memory plasticity.

Transfer Effects of Working Memory Intervention on Linguistic Abilities in Patients with Dementia

Purpose: Working memory training for Alzheimer’s disease (AD) patients may yield everyday cognitive- linguistic benefits by facilitating transfer effects in multiple domains. The purpose of this study was to investigate the effects of working memory intervention and differences on transfer effects in type of intervention paradigm like core training (CT) and strategy training (ST).Methods: A total of 24 patients with mild and moderate AD were divided into CT and ST group (n = 12, respectively). After CT and ST interventions, we assessed their transfer effects on linguistic abilities including reading comprehension, figurative language, word fluency, and discourse production. Results: There were three main findings. Firstly, CT group improved significantly in figurative language, word fluency, and discourse production. Secondly, ST group showed the significant intervention gains in figurative language and discourse production. Thirdly, CT group had higher transfer effects in figurative language and discourse production than ST group, while both were similar in other transfer effects.Conclusion: This study proves that effects of working memory intervention for AD patients are different in type of paradigm, and thereby presents a roadmap for increasing the efficacy and utilization of working memory intervention in clinical settings.

Selectively Enhanced Development of Working Memory in Musically Trained Children and Adolescents

In the current longitudinal study, we investigated the development of working memory in musically trained and nontrained children and adolescents, aged 9-20. We measured working memory with the Digit Span (DS) forwards and backwards tests (N = 106) and the Trail-Making A and B (TMT-A and B; N = 104) tests three times, in 2011, 2013, and 2016. We expected that musically trained participants would outperform peers with no musical training. Indeed, we found that the younger musically trained participants, in particular, outperformed their nontrained peers in the TMT-A, TMT-B and DS forwards tests. These tests all primarily require active maintenance of a rule in memory or immediate recall. In contrast, we found no group differences in the backwards test that requires manipulation and updating of information in working memory. These results suggest that musical training is more strongly associated with heightened working memory capacity and maintenance than enhanced working memory updating, especially in late childhood and early adolescence.

Multimodal cortical and hippocampal prediction of episodic-memory plasticity in young and older adults

Episodic memory can be trained in both early and late adulthood, but there is considerable variation in cognitive improvement across individuals. Which brain characteristics make some individuals benefit more than others? We used a multimodal approach to investigate whether volumetric magnetic resonance imaging (MRI) and resting-state functional MRI characteristics of the cortex and hippocampus, brain regions involved in episodic-memory function, were predictive of cognitive improvement after memory training. We hypothesized that these brain characteristics would differentially predict memory improvement in young and older adults, given the vulnerability of cortical regions as well as the hippocampus to healthy aging. Following structural and resting-state activity magnetic resonance scans, 50 young and 76 older participants completed 10 weeks of strategic episodic-memory training. Both age groups improved their memory performance, but the young adults more so than the older. Vertex-wise analyses of cortical volume showed no significant relation to memory benefit. When analyzing the two age groups separately, hippocampal volume was predictive of memory improvement in the group of older participants only. In this age group, the lower resting-state activity of the hippocampus was also predictive of memory improvement. Both volumetric and resting-state characteristics of the hippocampus explained unique variance of the improvement in the older participants suggesting that a multimodal imaging approach is valuable for the understanding of mechanisms underlying memory plasticity in aging.

Categorization Working Memory Span Task: Validation study of two Brazilian alternate versions

BACKGROUND

The Categorization Working Memory Span Task (CWMS task) is a complex working memory (WM) span test that has been used previously to assess age and individual differences in WM as well as the relationship between WM and complex aspects of cognition such as listening comprehension. Two alternate versions of the task have been developed to be used as outcome variables in WM training protocol, which mirrors the task involved in the CWMS task.

OBJECTIVES

(1) To translate and adapt the CWMS task for Brazilian Portuguese; (2) to test the equivalence of its 2 alternate versions; (3) to examine temporal stability; (4) to examine the influence of age and schooling on CWMS task; (5) to establish its relationship with other tests of WM.

METHODS

Eighty-one older adults completed version A, and 86 completed version B of the CWMS task. After 6 months, a subsample (n = 85) completed the same version of the task.

RESULTS

Versions A and B of the task generated comparable scores. Both versions had adequate temporal stability, which was higher for the CWMS total recall, which is the classical variable in this task to represent WM performance, when compared to the other variables generated by the test. The CWMS task variables were moderately correlated with schooling and other cognitive tests (Mini Mental State Examination, Letter-Number Sequencing, Spatial Span Backward, Digit Span Forward).

CONCLUSIONS

The 2 versions of the CWMS task were equivalent and stable temporally. The task was influenced by schooling and global cognition.

The early effects of external and internal strategies on working memory updating training

The mechanisms underlying working memory training remain unclear, but one possibility is that the typically limited transfer effects of this training reflect adoption of successful task-specific strategies. Our pre-registered randomized controlled trial (N = 116) studied the early effects of externally given vs. internally generated strategies in an updating task (n-back) over a 5-day period with a single 30-minute training session. Three groups were employed: n-back training with strategy instruction (n = 40), n-back training without strategy instruction (n = 37), and passive controls (n = 39). We found that both external and internal strategy use was associated with significantly higher posttest performance on the trained n-back task, and that training with n-back strategy instruction yielded positive transfer on untrained n-back tasks, resembling the transfer pattern typically seen after the ordinary uninstructed 4–6-week working memory training. In the uninstructed participants, the level of detail and type of internally generated n-back strategies at posttest was significantly related to their posttest n-back performance. Our results support the view that adoption of task-specific strategies plays an important role in working memory training outcomes, and that strategy-based effects are apparent right at the start of training.

Examining the role of rehearsal in old-old adults' working memory

We investigated the role of rehearsal in verbal working memory (WM) and whether WM capacity can be improved by a rehearsal instruction in very old age. In two experiments, we tested a total of 78 old-old adults (75 years and above) in one experimental session consisting of three assessment phases. First, participants worked on three different WM span tasks to assess their baseline performance. In the next phase, half of the participants received a rehearsal instruction to practice on two of the WM tasks, whereas the other half received no strategy instruction (Experiment 1) or worked on a filler task (Experiment 2). In the final phase, participants again worked on the three WM tasks. In Experiment 1, we found significant improvements for the WM tasks over time in both groups. However, we could not find a specific improvement for the rehearsal instruction due to a high spontaneous strategy use in the control group. When minimizing spontaneous strategy use in Experiment 2 by changing the task material, we found larger improvements in the instruction compared to the control group. However, we still found substantial spontaneous strategy use in the control group. The results indicate that rehearsal, as an essential component of verbal WM, is still intact and efficient in old-old adults. Furthermore, the spontaneous strategy use indicates that old-olds use their existing skills to cope with increasing WM demands. Finally, old-old adults benefited from an explicit rehearsal instruction showing potentials to boost WM capacity in this age group.

Self-initiated spatial working memory in young and older adults

The age-related decline in working memory (WM) has been studied extensively. Yet, research has focused mainly on one aspect of memory, in which older adults memorised information provided to them, neglecting the frequent everyday behaviour in which memory is self-initiated (SI), meaning that individuals memorise information they selected themselves. The present study used a modified spatial span task in which young and older adults memorised spatial sequences they constructed themselves, or random sequences provided to them. The results revealed that young and older adults carefully planned and constructed structured spatial sequences, by minimising distances between successive locations, and by selecting sequences with fewer path crossings and with more linear shapes. Older adults constructed sequences that were even more structured in some aspects. Young and older adults benefited from self-initiation to the same extent, showing similar age-related declines in SI and provided spatial WM. Overall, the study shows that older adults have access to metacognitive knowledge on the structure of efficient WM representations that benefit accuracy, and shows that older adults can use strategic encoding processes efficiently when encoding is SI. More generally, SI WM explores an important aspect of behaviour, demonstrating how older adults shape their environment to facilitate cognitive functioning.

Variation in strategy use across measures of verbal working memory

The working memory (WM) literature contains a number of tasks that vary on dimensions such as when or how memory items are reported. In addition to the ways in which WM tasks are designed to differ, tasks may also diverge according to the strategies participants use during task performance. The present study included seven tasks from the WM literature, each requiring short-term retention of verbal items. Following completion of a small number of trials from each task, individuals completed a self-report questionnaire to identify their primary strategy. Results indicated substantial variation across individuals for a given task, and within the same individual across tasks. Moreover, while direct comparisons between tasks showed that some tasks evinced similar patterns of strategy use despite differing task demands, others showed markedly different patterns of self-reported strategy use. A community detection algorithm, aimed at identifying groups of individuals based on their profile of strategic choices, revealed unique communities of individuals who are dependent on specific strategies under varying demands. Together, the findings suggest that researchers using common WM paradigms should very carefully consider the implications of variation in strategy use when interpreting their findings.

The effects of memory training on behavioral and microstructural plasticity in young and older adults

Age differences in human brain plasticity are assumed, but have not been systematically investigated. In this longitudinal study, we investigated changes in white matter (WM) microstructure in response to memory training relative to passive and active control conditions in 183 young and older adults. We hypothesized that (i) only the training group would show improved memory performance and microstructural alterations, (ii) the young adults would show larger memory improvement and a higher degree of microstructural alterations as compared to the older adults, and (iii) changes in memory performance would relate to microstructural alterations. The results showed that memory improvement was specific to the training group, and that both the young and older participants improved their performance. The young group improved their memory to a larger extent compared to the older group. In the older sample, the training group showed less age-related decline in WM microstructure compared to the control groups, in areas overlapping the corpus callosum, the cortico-spinal tract, the cingulum bundle, the superior longitudinal fasciculus, and the anterior thalamic radiation. Less microstructural decline was related to a higher degree of memory improvement. Despite individual adaptation securing sufficient task difficulty, no training-related group differences in microstructure were found in the young adults. The observed divergence of behavioral and microstructural responses to memory training with age is discussed within a supply-demand framework. The results demonstrate that plasticity is preserved into older age, and that microstructural alterations may be part of a neurobiological substrate for behavioral improvements in older adults. Hum Brain Mapp 38:5666-5680, 2017. © 2017 Wiley Periodicals, Inc.

No Evidence for Improved Associative Memory Performance Following Process-Based Associative Memory Training in Older Adults

Studies attempting to improve episodic memory performance with strategy instructions and training have had limited success in older adults: their training gains are limited in comparison to those of younger adults and do not generalize to untrained tasks and contexts. This limited success has been partly attributed to age-related impairments in associative binding of information into coherent episodes. We therefore investigated potential training and transfer effects of process-based associative memory training (i.e., repeated practice). Thirty-nine older adults (M_age = 68.8) underwent 6 weeks of either adaptive associative memory training or item recognition training. Both groups improved performance in item memory, spatial memory (object-context binding) and reasoning. A disproportionate effect of associative memory training was only observed for item memory, whereas no training-related performance changes were observed for associative memory. Self-reported strategies showed no signs of spontaneous development of memory-enhancing associative memory strategies. Hence, the results do not support the hypothesis that process-based associative memory training leads to higher associative memory performance in older adults.

Small Acute Benefits of 4 Weeks Processing Speed Training Games on Processing Speed and Inhibition Performance and Depressive Mood in the Healthy Elderly People: Evidence from a Randomized Control Trial

Background: Processing speed training using a 1-year intervention period improves cognitive functions and emotional states of elderly people. Nevertheless, it remains unclear whether short-term processing speed training such as 4 weeks can benefit elderly people. This study was designed to investigate effects of 4 weeks of processing speed training on cognitive functions and emotional states of elderly people.

Methods: We used a single-blinded randomized control trial (RCT). Seventy-two older adults were assigned randomly to two groups: a processing speed training game (PSTG) group and knowledge quiz training game (KQTG) group, an active control group. In PSTG, participants were asked to play PSTG (12 processing speed games) for 15 min, during five sessions per week, for 4 weeks. In the KQTG group, participants were asked to play KQTG (four knowledge quizzes) for 15 min, during five sessions per week, for 4 weeks. We measured several cognitive functions and emotional states before and after the 4 week intervention period.

Results: Our results revealed that PSTG improved performances in processing speed and inhibition compared to KQTG, but did not improve performance in reasoning, shifting, short term/working memory, and episodic memory. Moreover, PSTG reduced the depressive mood score as measured by the Profile of Mood State compared to KQTG during the 4 week intervention period, but did not change other emotional measures.

Discussion: This RCT first provided scientific evidence related to small acute benefits of 4 week PSTG on processing speed, inhibition, and depressive mood in healthy elderly people. We discuss possible mechanisms for improvements in processing speed and inhibition and reduction of the depressive mood.

Trial registration: This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (UMIN000022250).

Computer-based training for improving mental calculation in third- and fifth-graders

The literature on intervention programs to improve arithmetical abilities is fragmentary and few studies have examined training on the symbolic representation of numbers (i.e. Arabic digits). In the present research, three groups of 3rd- and 5th-grade schoolchildren were given training on mental additions: 76 were assigned to a computer-based strategic training (ST) group, 73 to a process-based training (PBT) group, and 71 to a passive control (PC) group. Before and after the training, the children were given a criterion task involving complex addition problems, a nearest transfer task on complex subtraction problems, two near transfer tasks on math fluency, and a far transfer task on numerical reasoning. Our results showed developmental differences: 3rd-graders benefited more from the ST, with transfer effects on subtraction problems and math fluency, while 5th-graders benefited more from the PBT, improving their response times in the criterion task. Developmental, clinical and educational implications of these findings are discussed.

The relationship between different exercise modes and visuospatial working memory in older adults: a cross-sectional study

The purpose of the study was to investigate the relationship between different exercise modes and visuospatial working memory in healthy older adults. A cross-sectional design was adopted. A total of 111 healthy older adults were enrolled in the study. They were classified by the exercise-related questionnaire to be in an open-skill group, closed-skill group or sedentary group. In experiment 1, the participants performed a visuospatial working memory task. The results indicated that both closed-skill (p < 0.05) and open-skill (p < 0.01) groups reached a higher accuracy than the sedentary group. Experiment 2 examined whether the exercise-induced benefit of working memory was manifested in passive maintenance or active manipulation of working memory which was assessed by visuospatial short-term memory task and visuospatial mental rotation task, respectively. The results showed that the open-skill (p < 0.01) group was more accurate than the sedentary group in the visuospatial short-term memory task, whereas the group difference in the visuospatial mental rotation task was not significant. These findings combined to suggest that physical exercise was associated with better visuospatial working memory in older adults. Furthermore, open-skill exercises that demand higher cognitive processing showed selective benefit for passive maintenance of working memory.

Combined Cognitive Training vs. Memory Strategy Training in Healthy Older Adults

As mnemonic utilization deficit in older adults associates with age-related decline in executive function, we hypothesized that memory strategy training combined with executive function training might induce larger training effect in memory and broader training effects in non-memory outcomes than pure memory training. The present study compared the effects of combined cognitive training (executive function training plus memory strategy training) to pure memory strategy training. Forty healthy older adults were randomly assigned to a combined cognitive training group or a memory strategy training group. A control group receiving no training was also included. Combined cognitive training group received 16 sessions of training (eight sessions of executive function training followed by eight sessions of memory strategy training). Memory training group received 16 sessions of memory strategy training. The results partly supported our hypothesis in that indeed improved performance on executive function was only found in combined training group, whereas memory performance increased less in combined training compared to memory strategy group. Results suggest that combined cognitive training may be less efficient than pure memory training in memory outcomes, though the influences from insufficient training time and less closeness between trained executive function and working memory could not be excluded; however it has broader training effects in non-memory outcomes.

CLINICAL TRIAL REGISTRATION

www.chictr.org.cn, identifier ChiCTR-OON-16007793.

Reading Aloud and Solving Simple Arithmetic Calculation Intervention (Learning Therapy) Improves Inhibition, Verbal Episodic Memory, Focus Attention and Processing Speed in Healthy Elderly People: Evidence from a Randomized Controlled Trial

Background: Previous reports have described that simple cognitive training using reading aloud and solving simple arithmetic calculations, so-called “learning therapy”, can improve executive functions and processing speed in the older adults. Nevertheless, it is not well-known whether learning therapy improve a wide range of cognitive functions or not. We investigated the beneficial effects of learning therapy on various cognitive functions in healthy older adults.

Methods: We used a single-blinded intervention with two groups (learning therapy group: LT and waiting list control group: WL). Sixty-four elderly were randomly assigned to LT or WL. In LT, participants performed reading Japanese aloud and solving simple calculations training tasks for 6 months. WL did not participate in the intervention. We measured several cognitive functions before and after 6 months intervention periods.

Results: Compared to WL, results revealed that LT improved inhibition performance in executive functions (Stroop: LT (Mean = 3.88) vs. WL (Mean = 1.22), adjusted p = 0.013 and reverse Stroop LT (Mean = 3.22) vs. WL (Mean = 1.59), adjusted p = 0.015), verbal episodic memory (Logical Memory (LM): LT (Mean = 4.59) vs. WL (Mean = 2.47), adjusted p = 0.015), focus attention (D-CAT: LT (Mean = 2.09) vs. WL (Mean = −0.59), adjusted p = 0.010) and processing speed compared to the WL control group (digit symbol coding: LT (Mean = 5.00) vs. WL (Mean = 1.13), adjusted p = 0.015 and Symbol Search (SS): LT (Mean = 3.47) vs. WL (Mean = 1.81), adjusted p = 0.014).

Discussion: This randomized controlled trial (RCT) can be showed the benefit of LT on inhibition of executive functions, verbal episodic memory, focus attention and processing speed in healthy elderly people. Our results were discussed under overlapping hypothesis.

Working memory training triggers delayed chromatin remodeling in the mouse corticostriatothalamic circuit

Working memory is a cognitive function serving goal-oriented behavior. In the last decade, working memory training has been shown to improve performance and its efficacy for the treatment of several neuropsychiatric disorders has begun to be examined. Neuroimaging studies have contributed to elucidate the brain areas involved but little is known about the underlying cellular events. A growing body of evidence has provided a link between working memory and relatively long-lasting epigenetic changes. However, the effects elicited by working memory training at the epigenetic level remain unknown. In this study we establish an animal model of working memory training and explore the changes in histone H3 acetylation (H3K9,14Ac) and histone H3 dimethylation on lysine 27 (H3K27Me2) triggered by the procedure in the brain regions of the corticostriatothalamic circuit (prelimbic/infralimbic cortex (PrL/IL), dorsomedial striatum (DMSt) and dorsomedial thalamus (DMTh)). Mice trained on a spontaneous alternation task showed improved alternation scores when tested with a retention interval that disrupts the performance of untrained animals. We then determined the involvement of the brain areas of the corticostriatothalamic circuit in working memory training by measuring the marker of neuronal activation c-fos. We observed increased c-fos levels in PrL/IL and DMSt in trained mice 90min after training. These animals also presented lower immunoreactivity for H3K9,14Ac in DMSt 24h but not 90min after the procedure. Increases in H3K27Me2, a repressive chromatin mark, were found in the DMSt and DMTh 24h after the task. Altogether, we present a mouse model to study the cellular underpinnings of working memory training and provide evidence indicating delayed chromatin remodeling towards repression triggered by the procedure.

Non Pharmacological Cognitive Enhancers - Current Perspectives

Cognition refers to the mental processes involved in thinking, knowing, remembering, judging, and problem solving. Cognitive dysfunctions are an integral part of neuropsychiatric disorders as well as in healthy ageing. Cognitive Enhancers are molecules that help improve aspects of cognition like memory, intelligence, motivation, attention and concentration. Recently, Non Pharmacological Cognitive Enhancers have gained popularity as effective and safe alternative to various established drugs. Many of these Non Pharmacological Cognitive Enhancers seem to be more efficacious compared to currently available Pharmacological Cognitive Enhancers. This review describes and summarizes evidence on various Non Pharmacological Cognitive Enhancers such as physical exercise, sleep, meditation and yoga, spirituality, nutrients, computer training, brain stimulation, and music. We also discuss their role in ageing and different neuro-psychiatric disorders, and current status of Cochrane database recommendations. We searched the Pubmed database for the articles and reviews having the terms 'non pharmacological and cognitive' in the title, published from 2000 till 2014. A total of 11 results displayed, out of which 10 were relevant to the review. These were selected and reviewed. Appropriate cross-references within the articles along with Cochrane reviews were also considered and studied.

Could training executive function improve treatment outcomes for eating disorders?

Current gold standard treatments for eating disorders (EDs) lack satisfactory efficacy, and traditional psychological treatments do not directly address executive functioning deficits underpinning ED pathology. The goal of this paper is to explore the potential for enhancing ED treatment outcomes by improving executive functioning deficits that have been demonstrated to underlie eating pathology. To achieve our objective, we (1) review existing evidence for executive functioning deficits that underpin EDs and consider the extent to which these deficits could be targeted in neurocognitive training programs, (2) present the evidence for the one ED neurocognitive training program well-studied to date (Cognitive Remediation Therapy), (3) discuss the utility of neurocognitive training programs that have been developed for other psychiatric disorders with similar deficits, and (4) provide suggestions for the future development and research of neurocognitive training programs for EDs. Despite the fact that the body of empirical work on neurocognitive training programs for eating disorders is very small, we conclude that their potential is high given the combined evidence for the role of deficits in executive functioning in EDs, the initial promise of Cognitive Remediation Training, and the success in treating related conditions with neurocognitive training. Based on the evidence to date, it appears that the development and empirical evaluation of neurocognitive training programs for EDs is warranted.

Improving Cognitive Function from Children to Old Age: A Systematic Review of Recent Smart Ageing Intervention Studies

Background. Cognitive functions are important for daily life at any age. One purpose of Smart Ageing is to investigate how to improve cognitive functions. This systematic review evaluates beneficial effects of the intervention on cognitive functions. Method. We conducted a systematic review of intervention studies of improvements of cognitive functions published or in press before December 2013. Because of the heterogeneity of the intervention programs, a systematic and critical review of the interventions and outcomes was conducted instead of a meta-analysis. Results. We identified nine completed and published studies, which were divided into four categories: cognitive training using video game, cognitive training using PC, cognitive training using paper and pencil, and exercise training. Review results showed that various intervention programs can improve cognitive functions such as executive functions, working memory, episodic memory, processing speed, and general cognitive ability/IQ. Conclusions. The systematic review demonstrated that some intervention programs can be effective for improving various aspects of cognitive functioning at any age. Some limitations to this review include its small sample size and heterogeneity of programs and cognitive function measures, in addition to unresolved issues such as transfer of everyday skills and effectiveness for nonhealthy people.

Prospective memory training in older adults and its relevance for successful aging

In research on cognitive plasticity, two training approaches have been established: (1) training of strategies to improve performance in a given task (e.g., encoding strategies to improve episodic memory performance) and (2) training of basic cognitive processes (e.g., working memory, inhibition) that underlie a range of more complex cognitive tasks (e.g., planning) to improve both the training target and the complex transfer tasks. Strategy training aims to compensate or circumvent limitations in underlying processes, while process training attempts to augment or to restore these processes. Although research on both approaches has produced some promising findings, results are still heterogeneous and the impact of most training regimes for everyday life is unknown. We, therefore, discuss recent proposals of training regimes aiming to improve prospective memory (i.e., forming and realizing delayed intentions) as this type of complex cognition is highly relevant for independent living. Furthermore, prospective memory is associated with working memory and executive functions and age-related decline is widely reported. We review initial evidence suggesting that both training regimes (i.e., strategy and/or process training) can successfully be applied to improve prospective memory. Conceptual and methodological implications of the findings for research on age-related prospective memory and for training research in general are discussed.

Individual differences in cognitive plasticity: an investigation of training curves in younger and older adults

To date, cognitive intervention research has provided mixed but nevertheless promising evidence with respect to the effects of cognitive training on untrained tasks (transfer). However, the mechanisms behind learning, training effects and their predictors are not fully understood. Moreover, individual differences, which may constitute an important factor impacting training outcome, are usually neglected. We suggest investigating individual training performance across training sessions in order to gain finer-grained knowledge of training gains, on the one hand, and assessing the potential impact of predictors such as age and fluid intelligence on learning rate, on the other hand. To this aim, we propose to model individual learning curves to examine the intra-individual change in training as well as inter-individual differences in intra-individual change. We recommend introducing a latent growth curve model (LGCM) analysis, a method frequently applied to learning data but rarely used in cognitive training research. Such advanced analyses of the training phase allow identifying factors to be respected when designing effective tailor-made training interventions. To illustrate the proposed approach, a LGCM analysis using data of a 10-day working memory training study in younger and older adults is reported.

Does strategy training reduce age-related deficits in working memory?

BACKGROUND

Older adults typically perform worse on measures of working memory (WM) than do young adults; however, age-related differences in WM performance might be reduced if older adults use effective encoding strategies.

OBJECTIVE

The purpose of the current experiment was to evaluate WM performance after training individuals to use effective encoding strategies.

METHODS

Participants in the training group (older adults: n = 39; young adults: n = 41) were taught about various verbal encoding strategies and their differential effectiveness and were trained to use interactive imagery and sentence generation on a list-learning task. Participants in the control group (older: n = 37; young: n = 38) completed an equally engaging filler task. All participants completed a pre- and post-training reading span task, which included self-reported strategy use, as well as two transfer tasks that differed in the affordance to use the trained strategies - a paired-associate recall task and the self-ordered pointing task.

RESULTS

Both young and older adults were able to use the target strategies on the WM task and showed gains in WM performance after training. The age-related WM deficit was not greatly affected, however, and the training gains did not transfer to the other cognitive tasks. In fact, participants attempted to adapt the trained strategies for a paired-associate recall task, but the increased strategy use did not benefit their performance.

CONCLUSIONS

Strategy training can boost WM performance, and its benefits appear to arise from strategy-specific effects and not from domain-general gains in cognitive ability.

Effects and mechanisms of working memory training: a review

Can cognitive abilities such as reasoning be improved through working memory training? This question is still highly controversial, with prior studies providing contradictory findings. The lack of theory-driven, systematic approaches and (occasionally serious) methodological shortcomings complicates this debate even more. This review suggests two general mechanisms mediating transfer effects that are (or are not) observed after working memory training: enhanced working memory capacity, enabling people to hold more items in working memory than before training, or enhanced efficiency using the working memory capacity available (e.g., using chunking strategies to remember more items correctly). We then highlight multiple factors that could influence these mechanisms of transfer and thus the success of training interventions. These factors include (1) the nature of the training regime (i.e., intensity, duration, and adaptivity of the training tasks) and, with it, the magnitude of improvements during training, and (2) individual differences in age, cognitive abilities, biological factors, and motivational and personality factors. Finally, we summarize the findings revealed by existing training studies for each of these factors, and thereby present a roadmap for accumulating further empirical evidence regarding the efficacy of working memory training in a systematic way.

The efficacy of a multifactorial memory training in older adults living in residential care settings

BACKGROUND

Several studies have shown an increase in memory performance after teaching mnemonic techniques to older participants. However, transfer effects to non-trained tasks are generally either very small, or not found.

METHODS

The present study investigates the efficacy of a multifactorial memory training program for older adults living in a residential care center. The program combines teaching of memory strategies with activities based on metacognitive (metamemory) and motivational aspects. Specific training-related gains in the Immediate list recall task (criterion task), as well as transfer effects on measures of short-term memory, long-term memory, working memory, motivational (need for cognition), and metacognitive aspects (subjective measure of one's memory) were examined. Maintenance of training benefits was assessed after seven months. Fifty-one older adults living in a residential care center, with no cognitive impairments, participated in the study. Participants were randomly assigned to two programs: the experimental group attended the training program, while the active control group was involved in a program in which different psychological issues were discussed.

RESULTS

A benefit in the criterion task and substantial general transfer effects were found for the trained group, but not for the active control, and they were maintained at the seven months follow-up.

CONCLUSION

Our results suggest that training procedures, which combine teaching of strategies with metacognitive-motivational aspects, can improve cognitive functioning and attitude toward cognitive activities in older adults.