Verbal learning changes in older adults across 18 months

Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis (Preprint).. [DOI: 10.2196/preprints.43607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis.

OBJECTIVE

This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment.

METHODS

Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate.

RESULTS

Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (<i>P</i>=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (<i>P</i>=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (<i>P</i>=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; <i>P</i>=.03) and conventional cognitive training (2/11, 18%; <i>P</i>&lt;.001) in enhancing nonverbal learning.

CONCLUSIONS

Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods.

CLINICALTRIAL

PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa

Rostral locus coeruleus integrity is associated with better memory performance in older adults

For decades, research into memory decline in human cognitive ageing has focused on neocortical regions, the hippocampus and dopaminergic neuromodulation. Recent findings indicate that the locus coeruleus (LC) and noradrenergic neuromodulation may also play an important role in shaping memory development in later life. However, technical challenges in quantification of LC integrity have hindered the study of LC-cognition associations in humans. Using high-resolution, neuromelanin-sensitive magnetic resonance imaging, we found that individual differences in learning and memory were positively associated with LC integrity across a variety of memory tasks in both younger (n = 66) and older adults (n = 228). Moreover, we observed functionally relevant age differences confined to rostral LC. Older adults with a more 'youth-like' rostral LC also showed higher memory performance. These findings link non-invasive, in vivo indices of LC integrity to memory in ageing and highlight the role of the LC norepinephrine system in the decline of cognition.

Individual differences in criterion-based dropout learning in old age: the role of processing speed and verbal knowledge

In the present study, individual differences in criterion-based dropout learning in old age were investigated. The predictive role of processing speed and verbal knowledge for individual differences in this type of learning was analyzed. Learning trajectories were modeled using a multilevel approach based on N = 47 older participants (M_age = 69.3, SD = 6.4). Participants learned five lists of eight cue-target word pairs across six study-test cycles maximally possible. Results indicate that there were reliable individual differences in the initial level, speed of learning, and quadratic growth of learning. After adjusting for age-related effects, both higher verbal knowledge and higher processing speed had a positive effect on speed of learning. Additionally, verbal knowledge had a negative effect on quadratic growth of learning. Speed of learning and quadratic growth had a positive effect on a delayed recall test after adjusting for effects of processing speed and verbal knowledge. These results emphasize the role of cognitive abilities for individual differences in criterion-based dropout learning in old age.

Intensive Measurement Designs for Research on Aging

Intensive measurement burst designs permit analysis of behavioral and biological processes as they unfold over short and long periods of time and providing the opportunity to identify change from an individual's normative level of functioning. The measurement burst design permits statistical decomposition of short-term variation and learning effects that overlay normative aging and provide stronger bases for detecting accelerated change due to pathological processes. We provide an overview of design features and analysis of measurement burst data in Project MIND. The objective of intensive measurement designs is to obtain greater resolution of processes of interest that permit reliable and sensitive assessments of functioning and change in functioning and of key determinants underlying short-term variation and long-term aging and health-related change.

The factorial structure and external validity of the prospective and retrospective memory questionnaire in older adults

The factorial structure of the Prospective and Retrospective Memory Questionnaire (PRMQ) was investigated in a sample of 336 older adults (aged 66-81 years). Confirmatory factor analyses showed that a bifactor model of two correlated factors of prospective and retrospective memory problems and two uncorrelated group factors of positively and negatively worded items had the best fit. Such a model can be seen as a multitrait-multi-method model that separates the substantive and methodological components among the items of the PRMQ. Correlations of the four factors with external criteria (affect, neuroticism, prospective, and retrospective memory performance) revealed that the item wording factors mainly correlate with the affect variables, whereas the prospective and retrospective memory problem factors were differentially associated with memory performance. As a conceptual conclusion, these differential correlations give support to the discriminant validity of subjective prospective versus retrospective memory problems.