Leveraging technology to personalize cognitive enhancement methods in aging

Closed-Loop Systems and Real-Time Neurofeedback in Mindfulness Meditation Research

Mindfulness meditation has numerous purported benefits to psychological wellbeing, however, problems such as adherence to mindfulness tasks, quality of mindfulness sessions, or dosage of mindfulness interventions may hinder individuals from accessing the purported benefits of mindfulness. Methodologies including closed-loop systems and real-time neurofeedback may provide tools to help bolster success in mindfulness task performance, titrate the exposure to mindfulness interventions, or improve engagement with mindfulness sessions. This review explores the use of closed-loop systems and real-time neurofeedback to influence, augment, or promote mindfulness interventions. Various closed-loop neurofeedback signals from functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) have been used to provide subjective correlates to mindfulness states including: fMRI region-of-interest based signals (e.g., posterior cingulate cortex), fMRI network-based signals (e.g., default mode network, central executive network, salience network), and EEG spectral-based signals (e.g., alpha, theta, and gamma bands). Past research has focused on how successful interventions has aligned with the subjective mindfulness meditation experience. Future research may pivot towards using appropriate control conditions (e.g., mindfulness-only or sham-neurofeedback) to quantify the effects of closed-loop systems and neurofeedback-guided mindfulness meditation in improving cognition and wellbeing.

Bibliometric study of scientific productivity in intervention programs that improve cognitive impairment in older adults

Realizar un análisis bibliométrico integral de la productividad científica relacionada con programas de intervención que buscan mejorar la función cognitiva en adultos mayores, según revista, país y tema de intervención en la base de datos pubmed. Se realizó un estudio bibliométrico durante el periodo 2018 al 2023. La búsqueda bibliográfica se realizó en la base de datos PubMed. Los términos de búsqueda fueron: cognitivecayden, cognitivecayden, exercise program, intervention program, physical exercise,older adult, elderly. Cada artículo identificó: año de publicación, idioma de publicación, país de publicación, nombre de la revista y tema del estudio. Se utilizaron los lineamientos establecidos por PRISMA. Se incluyeron 51 publicaciones científicas, analizadas en 34 revistas. China lidera con 14 estudios (27,5%), seguido de Estados Unidos con 5 artículos (9,8%). Corea y Singapur están en tercer lugar con 4 estudios cada uno (7,8%), seguido de Japón con 3 estudios (5,9%). En cuanto al idioma de publicación, el 96,1% (n=49) fueron publicados en inglés. Solo el 3,9% (n=2) fueron publicados en español. La revista con mayor frecuencia de publicaciones fue Nutrients, con 6 artículos publicados, lo que representa el 11,8% del total y destaca como líder en este campo. Le siguió BMC Geriatrics con 3 artículos publicados, lo que representa el 5,9% del total. Destaca el aumento de las investigaciones sobre intervenciones para el deterioro cognitivo en OA, concentradas principalmente en los años 2020 y 2023. China lidera la producción de estudios seguida de Estados Unidos, Corea y Singapur. Los programas de intervención más estudiados incluyen el ejercicio y el deporte, seguido de la nutrición y el entrenamiento computarizado. Destaca la revista "Nutrients" con mayor número de artículos, seguida de "BMC Geriatrics".

Understanding Digital Dementia and Cognitive Impact in the Current Era of the Internet: A Review

Dementia encompasses symptoms resulting from brain damage that impairs cognitive functions, surpassing natural aging effects. This condition affects emotional regulation, behavior, and motivation while preserving consciousness. Dr. Manfred Spitzer coined the term 'digital dementia,' highlighting the cognitive decline associated with excessive reliance on digital devices such as smartphones and Google, potentially exacerbating attention deficit hyperactivity disorder (ADHD) and memory loss. This condition mirrors terms like 'digital amnesia' and 'the Google Effect,' highlighting the brain's tendency to offload peripheral information, leading to panic and forgetfulness. Spitzer's book, Digital Dementia, focuses on gaming effects on children and has thus popularized the term. Teenagers are known to use electronic devices regularly, correlating with rising cognitive impairments. The advent of the internet's fifth generation (5G) has transformed technology use, impacting mental health treatments and clinical practices globally. Digital media's influence on the developing brain encompasses motor skills, language, and cognition. Excessive digital media use in young adults correlates with lower cognitive empathy, affecting interpersonal understanding and facial recognition. Studies link heavy reliance on web-based media to decreased white matter integrity, crucial for language skills. Adolescents may be more vulnerable to anxiety and unrealistic expectations due to digital media overuse.  Digital media overuse impacts brain development, especially cognitive and inhibitory control, attention, memory, and reasoning, essential for adapting to dynamic environments. Early exposure to fast-paced media can impair motor skills, spatial awareness, problem-solving, and language learning. Neuroimaging studies reveal that environmental factors like screen usage affect brain networks controlling social-emotional behavior and executive functions. Overreliance on smartphones diminishes gray matter in key brain regions, affecting cognitive and emotional regulation. The internet generation, characterized by advancements such as Web 3.0, introduces artificial intelligence and semantic web technologies, reshaping digital content processing. The neurobiological basis of digital dementia involves changes in the brain structure and function, with excessive screen exposure linked to cognitive impairments. Neuroplasticity, or the brain's adaptability, plays a role in cognitive decline from digital media overuse. Early childhood and adolescent brain development stages exhibit significant plasticity, influencing cognitive trajectories.  Addressing digital dementia requires strategies to reduce screen time, promote cognitive exercises, and enhance awareness. Parents should regulate children's screen usage, encourage digital detox periods, and substitute screen time with other activities. Cognitive training programs such as Cogmed (Neural Assembly Int AB, Stockholm, SWE) and CogniFit (San Francisco, CA, USA) can improve memory and attention in older adults. Promoting balanced technology use and educating on the risks of excessive digital media consumption is crucial for maintaining cognitive health in the digital age.

Digital assessment of cognitive-affective biases related to mental health

With an increasing societal need for digital therapy solutions for poor mental health, we face a corresponding rise in demand for scientifically validated digital contents. In this study we aimed to lay a sound scientific foundation for the development of brain-based digital therapeutics to assess and monitor cognitive effects of social and emotional bias across diverse populations and age-ranges. First, we developed three computerized cognitive tasks using animated graphics: 1) an emotional flanker task designed to test attentional bias, 2) an emotional go-no-go task to measure bias in memory and executive function, and 3) an emotional social evaluation task to measure sensitivity to social judgments. Then, we confirmed the generalizability of our results in a wide range of samples (children (N = 50), young adults (N = 172), older adults (N = 39), online young adults (N=93), and depression patients (N = 41)) using touchscreen and online computer-based tasks, and devised a spontaneous thought generation task that was strongly associated with, and therefore could potentially serve as an alternative to, self-report scales. Using PCA, we extracted five components that represented different aspects of cognitive-affective function (emotional bias, emotional sensitivity, general accuracy, and general/social attention). Next, a gamified version of the above tasks was developed to test the feasibility of digital cognitive training over a 2-week period. A pilot training study utilizing this application showed decreases in emotional bias in the training group (that were not observed in the control group), which was correlated with a reduction in anxiety symptoms. Using a 2-channel wearable EEG system, we found that frontal alpha and gamma power were associated with both emotional bias and its reduction across the 2-week training period.

Vision-based estimation of fatigue and engagement in cognitive training sessions

Computerized cognitive training (CCT) is a scalable, well-tolerated intervention that has promise for slowing cognitive decline. The effectiveness of CCT is often affected by a lack of effective engagement. Mental fatigue is a the primary factor for compromising effective engagement in CCT, particularly in older adults at risk for dementia. There is a need for scalable, automated measures that can constantly monitor and reliably detect mental fatigue during CCT. Here, we develop and validate a novel Recurrent Video Transformer (RVT) method for monitoring real-time mental fatigue in older adults with mild cognitive impairment using their video-recorded facial gestures during CCT. The RVT model achieved the highest balanced accuracy (79.58%) and precision (0.82) compared to the prior models for binary and multi-class classification of mental fatigue. We also validated our model by significantly relating to reaction time across CCT tasks (Waldχ2=5.16,p=0.023). By leveraging dynamic temporal information, the RVT model demonstrates the potential to accurately measure real-time mental fatigue, laying the foundation for future CCT research aiming to enhance effective engagement by timely prevention of mental fatigue.

Cortical processes of multisensory plausibility modulation of vibrotactile perception in virtual environments in middled-aged and older adults

Digital technologies, such as virtual or augmented reality, can potentially support neurocognitive functions of the aging populations worldwide and complement existing intervention methods. However, aging-related declines in the frontal-parietal network and dopaminergic modulation which progress gradually across the later periods of the adult lifespan may affect the processing of multisensory congruence and expectancy based contextual plausibility. We assessed hemodynamic brain responses while middle-aged and old adults experienced car-riding virtual-reality scenarios where the plausibility of vibrotactile stimulations was manipulated by delivering stimulus intensities that were either congruent or incongruent with the digitalized audio-visual contexts of the respective scenarios. Relative to previous findings observed in young adults, although highly plausible vibrotactile stimulations confirming with contextual expectations also elicited higher brain hemodynamic responses in middle-aged and old adults, this effect was limited to virtual scenarios with extreme expectancy violations. Moreover, individual differences in plausibility-related frontal activity did not correlate with plausibility violation costs in the sensorimotor cortex, indicating less systematic frontal context-based sensory filtering in older ages. These findings have practical implications for advancing digital technologies to support aging societies.

Cognitive and neuroscientific perspectives of healthy ageing

With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.

Recent Advances in Biomimetics for the Development of Bio-Inspired Prosthetic Limbs

Recent advancements in biomimetics have spurred significant innovations in prosthetic limb development by leveraging the intricate designs and mechanisms found in nature. Biomimetics, also known as "nature-inspired engineering", involves studying and emulating biological systems to address complex human challenges. This comprehensive review provides insights into the latest trends in biomimetic prosthetics, focusing on leveraging knowledge from natural biomechanics, sensory feedback mechanisms, and control systems to closely mimic biological appendages. Highlighted breakthroughs include the integration of cutting-edge materials and manufacturing techniques such as 3D printing, facilitating seamless anatomical integration of prosthetic limbs. Additionally, the incorporation of neural interfaces and sensory feedback systems enhances control and movement, while technologies like 3D scanning enable personalized customization, optimizing comfort and functionality for individual users. Ongoing research efforts in biomimetics hold promise for further advancements, offering enhanced mobility and integration for individuals with limb loss or impairment. This review illuminates the dynamic landscape of biomimetic prosthetic technology, emphasizing its transformative potential in rehabilitation and assistive technologies. It envisions a future where prosthetic solutions seamlessly integrate with the human body, augmenting both mobility and quality of life.

Smartphone-delivered approach bias modification for reducing harmful drinking amongst middle-older age adults: Secondary analyses of a single-arm pilot study

INTRODUCTION

Novel, scalable, low-cost interventions are needed to reduce harmful drinking amongst middle-older adults. Approach bias modification (ApBM) is a promising form of cognitive training for preventing/reducing alcohol use that can be delivered via smartphone. This study explored the acceptability and preliminary effectiveness of smartphone delivered and personalised ApBM amongst Australians ≥55 years, an age cohort at risk of alcohol-related harms.

METHODS

Secondary analyses in a middle-older adult subsample (≥55 years, n = 289) of an open-label pilot study using a retrospective, repeated measures design. We explored acceptability (adherence, user mobile acceptability ratings, free-text responses) and preliminary effectiveness (changes in drinking quantity and frequency, craving, dependence and proportion drinking within government-recommended guidelines) of two sessions/week over 4 weeks of evidence-based ApBM training, adapted to include personalisation and smartphone delivery amongst Australians ≥55 years.

RESULTS

Although minor adaptations to training were suggested, the intervention was acceptable amongst survey completers, with 72% training adherence. Relative to baseline, there was a significant increase in the proportion of drinking within recommended single-session and weekly guidelines post-training (from 25% to 41% and 6% to 28%, respectively, p < 0.001), with past-week standard drinks significantly decreasing by 18% (p < 0.001) and significant reductions in drinking days, mean craving and dependence scores (p < 0.001).

DISCUSSION AND CONCLUSIONS

Findings suggest smartphone ApBM is acceptable amongst middle-to-older aged Australians and may support this 'at risk' cohort to remain within government-recommended alcohol consumption guidelines to optimise healthy aging, although, in the context of a single-arm study, preliminary results should be interpreted cautiously.

Antiaging Strategies and Remedies: A Landscape of Research Progress and Promise

Aging is typified by a gradual loss of physiological fitness and accumulation of cellular damage, leading to deteriorated functions and enhanced vulnerability to diseases. Antiaging research has a long history throughout civilization, with many efforts put forth to understand and prevent the effects of aging. Multiple strategies aiming to promote healthy aging and extend the lifespan have been developed including lifestyle adjustments, medical treatments, and social programs. A multitude of antiaging medicines and remedies have also been explored. Here, we use data from the CAS Content Collection to analyze the publication landscape of recent research related to antiaging strategies and treatments. We review the recent advances and delineate trends in research headway of antiaging knowledge and practice across time, geography, and development pipelines. We further assess the state-of-the-art antiaging approaches and explore their correlations with age-related diseases. The landscape of antiaging drugs has been outlined and explored. Well-recognized and novel, currently evaluated antiaging agents have also been summarized. Finally, we review clinical applications of antiaging products with their development pipelines. The objective of this review is to summarize current knowledge on preventive strategies and treatment remedies in the field of aging, to outline challenges and evaluate growth opportunities, in order to further efforts to solve the problems that remain.

Validation of At-Home Application of a Digital Cognitive Screener for Older Adults

Standardized neuropsychological assessments of older adults are important for both clinical diagnosis and biobehavioral research. Over decades, in-person testing has been the basis for population normative values that rank cognitive performance by demographic status. Most recently, digital tools have enabled remote data collection for cognitive measures, which offers the significant promise to extend the basis for normative values to be more inclusive of a larger cross section of the older population. We developed a Remote Characterization Module (RCM), using a speech-to-text interface, as a novel digital tool to administer an at-home, 25-min cognitive screener that mimics eight standardized neuropsychological measures. Forty cognitively healthy participants were recruited from a longitudinal aging research cohort, and they performed the same measures of memory, attention, verbal fluency and set-shifting in both in-clinic paper-and-pencil (PAP) and at-home RCM versions. The results showed small differences, if any, for how participants performed on in-person and remote versions in five of eight tasks. Critically, robust correlations between their PAP and RCM scores across participants support the finding that remote, digital testing can provide a reliable assessment tool for rapid and remote screening of healthy older adults' cognitive performance in several key domains. The implications for digital cognitive screeners are discussed.