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Marselli G, Favieri F, Forte G, Corbo I, Agostini F, Guarino A, Casagrande M. The protective role of cognitive reserve: an empirical study in mild cognitive impairment. BMC Psychol 2024; 12:334. [PMID: 38849930 PMCID: PMC11157959 DOI: 10.1186/s40359-024-01831-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) describes an aging profile characterized by a cognitive decline that is worse than expected in normal aging but less pervasive and critical than full-blown dementia. In the absence of an effective treatment strategy, it is important to identify factors that can protect against progression to dementia. In this field, it is hypothesized that one aspect that may be a protective factor against the neurotypical outcome of dementia is cognitive reserve (CR). Cognitive reserve is the ability to maintain cognitive functionality despite accumulating brain pathology. OBJECTIVES The present study aimed to identify and analyze the differences in CR between healthy adults and patients with MCI. Specifically, it is hypothesized that (i) healthy older adult people have higher CR than older adult people diagnosed with MCI, and (II) CR could predict the classification of subjects into people with or without MCI. METHODS Two hundred forty-three adults (mean age = 60.4, SD = 7.4) participated in the present study and were classified into three groups based on Petersen's MCI criteria: healthy controls (HC), amnestic MCI (aMCI), and non-amnestic MCI (naMCI). The Cognitive Reserve Index questionnaire (CRIq) was administered to assess the level of CR, FINDINGS: Results showed that HC had significantly higher CR scores than participants diagnosed with aMCI and naMCI. Moreover, a binomial logistic regression suggested that low CR was a significant risk factor for the MCI diagnosis. CONCLUSIONS The clinical picture that emerged from the results showed that lower CR could be considered a characteristic of pathological aging, such as MCI.Public significance statement, Since the brain attempts to cope with life-related changes or pathologies, it is fundamental for both clinicians and researchers to investigate further the factors that contribute to brain resilience. As an indirect expression of brain reserve, cognitive reserve may be both a marker and a predictor of adaptive aging.
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Affiliation(s)
- Giulia Marselli
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Francesca Favieri
- Department of Dynamic and Clinical Psychology and Health, "Sapienza" University of Rome, Via degli Apuli 1, Rome, 00184, Italy
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health, "Sapienza" University of Rome, Via degli Apuli 1, Rome, 00184, Italy
| | - Ilaria Corbo
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | | | | | - Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health, "Sapienza" University of Rome, Via degli Apuli 1, Rome, 00184, Italy.
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Jesus AG, Lima MPD, Vilar M, Pachana NA. HEPPI: a randomized controlled trial of the efficacy of a cognitive-emotional intervention for homebound older adults. Aging Ment Health 2024; 28:491-501. [PMID: 37747057 DOI: 10.1080/13607863.2023.2260760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. METHODS Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. RESULTS Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. CONCLUSIONS This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
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Cheung MC, Sze SL, Chan AS. Chanwuyi Lifestyle Medicine Program Improves Memory and Executive Functions of Older Adults With Mild Cognitive Impairment. Am J Alzheimers Dis Other Demen 2024; 39:15333175241255744. [PMID: 38764310 PMCID: PMC11104026 DOI: 10.1177/15333175241255744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
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.
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Affiliation(s)
- Mei-Chun Cheung
- Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Sophia L. Sze
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Agnes S. Chan
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Lissek VJ, Orth S, Suchan B. go4cognition: Evaluation of a Newly Developed Multicomponent Intervention in Mild Cognitive Impairment. J Alzheimers Dis 2024; 99:377-392. [PMID: 38669526 DOI: 10.3233/jad-230802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background Cognitive training and physical exercise show positive effects on cognitive decline in subjects with mild cognitive impairment (MCI). Multimodal interventions for MCI patients, combining physical and cognitive training in a social context seem to slow down cognitive decline. Objective Based on a previous study, a new mobile gamification tool (go4cognition; https://www.ontaris.de/go4cognition) has been developed to train cognitive and physical functions simultaneously in a group setting. It involves tasks targeting various cognitive functions (short-term memory, working memory, executive functions). The computer-based setup allows for individual performance analysis. This study evaluated the effects of this tool. Methods 30 participants with MCI, as defined by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) cut-off-score, aged between 66 and 89 years, trained for one hour two days a week for twelve weeks. Additionally, standard neuropsychological assessment of memory and attention was carried out before and after the intervention. Results The go4cognition device is highly effective in improving various cognitive functions. A significant improvement in the CERAD total score resulting in re-classification of 70% of former MCI patients into non-MCI patients was found. Additionally, an improvement of verbal fluency, verbal memory, spatial memory, and attention was observed. Furthermore, the CERAD total score was significantly correlated with performance in the go4cognition tool. Conclusions The results of the intervention support the idea of the effectiveness of a combined cognitive and motor intervention by incorporating neuropsychological paradigms in a group setting and suggest a close relation between combined cognitive and physical exercise and cognitive performance.
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Affiliation(s)
- Vanessa J Lissek
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| | | | - Boris Suchan
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
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Xue B, Meng X, Liu Q, Luo X. The effect of receptive music therapy on older adults with mild cognitive impairment and depression: a randomized controlled trial. Sci Rep 2023; 13:22159. [PMID: 38092791 PMCID: PMC10719334 DOI: 10.1038/s41598-023-49162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
This study aims to evaluate the effects of a receptive music therapy intervention on cognitive functions and depressive symptoms in older adults with MCI. A randomized controlled trial was conducted in Wuhan, China. Eighty older adults, over 65, who had MCI and depression symptoms were randomly divided into the intervention and control groups. The intervention group received usual nursing care plus receptive music therapy intervention four times a week, for eight weeks; the control group received usual nursing care during the same period. The linear regression analysis was used to compare the difference between groups. There was a significant difference in the intervention group for the pre-intervention and post-intervention scores of cognitive function and depression. There was no significant difference in the control group before and after the study period and a significant between-group difference in both cognitive function and depression. In conclusion, receptive music therapy intervention significantly improved cognitive function and reduced depressive symptoms in older adults with MCI. It could be widely used in communities and nursing homes to improve the quality of life of older adults.
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Affiliation(s)
- Bing Xue
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xianmei Meng
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
| | - Qiuxia Liu
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
| | - Xianwu Luo
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China.
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Gómez-Soria I, Iguacel I, Cuenca-Zaldívar JN, Aguilar-Latorre A, Peralta-Marrupe P, Latorre E, Calatayud E. Cognitive stimulation and psychosocial results in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 115:105114. [PMID: 37451002 DOI: 10.1016/j.archger.2023.105114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Cognitive stimulation (CS) is a popular and cost-effective intervention, which applies different types of techniques focused on cognitive skills and can be administered by different professionals. CS can be defined as activities that involve cognitive processing usually conducted in a social context and often in a group. Therefore, CS can improve psychosocial functioning and quality of life (QoL), depression, anxiety and activities of daily living (ADLs) independent of the pharmacological treatment such as acetylcholinesterase inhibitors. The objective of this systematic review and meta-analysis was to evaluate the effects of CS on psychosocial outcomes in older adults (aged 65 years or over), with healthy cognitive ageing, mild cognitive impairment (MCI), and dementia. METHODS PubMed, Scopus and Web of Science databases were examined from inception to October 2021. A total of 1,997 studies were initially identified in these databases. After discarding studies that did not meet the inclusion criteria, 30 studies were finally included in the systematic review and the meta-analysis performed with robust variance estimator (RVE) due the inclusion of studies with repeated measurements. The quality assessment tools from the National Institutes of Health were used to evaluate the quality of the studies. RESULTS CS was significantly associated with a higher QoL in participants who received personalized/adapted CS (RVE = 0.11±0.19 [-0.76, 0.99], t(1.86) = 0.6, p = 0.61). . CONCLUSION Personalized/adapted CS seems to improve QoL in older adults.
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Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Isabel Iguacel
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Spain.
| | - Juan Nicolás Cuenca-Zaldívar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), 28222 Majadahonda (Madrid), Spain; Primary Health Center "El Abajon", 28231 Las Rozas de Madrid, Spain; Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | | - Eva Latorre
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, University of Zaragoza, Spain
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
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Zhang M, Ho E, Nowinski CJ, Fox RS, Ayturk E, Karpouzian-Rogers T, Novack M, Dodge HH, Weintraub S, Gershon R. The Paradox in Positive and Negative Aspects of Emotional Functioning Among Older Adults with Early Stages of Cognitive Impairment. J Aging Health 2023:8982643231199806. [PMID: 37800686 DOI: 10.1177/08982643231199806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Introduction: Emotional functioning in older adults is influenced by normal aging and cognitive impairment, likely heterogeneous across positive versus negative aspects of emotional functioning. Little is known about positive emotional experiences at the early stages of cognitive impairment. Methods: We assessed different aspects of emotional functioning among 448 participants aged 65+ (Normal Control (NC) = 276, Mild Cognitive Impairment (MCI) = 103, and mild dementia of the Alzheimer type (mild DAT) = 69) and tested moderators. Results: Compared to NC, older adults with MCI and mild DAT have maintained many positive aspects of emotional functioning, despite higher levels of negative affect, sadness, and loneliness. Among the oldest-old, the mild DAT group experienced higher fear and lower self-efficacy. Discussion: Older adults at early stages of cognitive impairment can experience positive aspects of emotional functioning, such as positive affect, purpose, and life satisfaction, all of which are important buildable psychological resources for coping.
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Affiliation(s)
- Manrui Zhang
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Emily Ho
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Cindy J Nowinski
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- College of Nursing, University of Arizona, Tuscon, AZ, USA
| | - Ezgi Ayturk
- College of Social Sciences and Humanities, KOC Universitesi, Istanbul, Turkey
| | - Tatiana Karpouzian-Rogers
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Miriam Novack
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Hiroko H Dodge
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Richard Gershon
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
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Park JY, Choi SA, Kim JJ, Park YJ, Kim CK, Cho GJ, Koh SB, Kang SH. Effect of Tablet-based Cognitive Intervention on Cognition in Patients With Mild Cognitive Impairment: A Pilot Study. Dement Neurocogn Disord 2023; 22:130-138. [PMID: 38025410 PMCID: PMC10654482 DOI: 10.12779/dnd.2023.22.4.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Purpose Growing evidence has shown that cognitive interventions can mitigate cognitive decline in patients with mild cognitive impairment (MCI). However, most previous cognitive interventions have been group-based programs. Due to their intrinsic limitations, group-based programs are not widely used in clinical practice. Therefore, we have developed a tablet-based cognitive intervention program. This preliminary study investigated the feasibility and effects of a 12-week structured tablet-based program on cognitive function in patients with MCI. Methods We performed a single-arm study on 24 patients with MCI. The participants underwent a tablet-based cognitive intervention program 5 times a week over a 12-week period. The primary outcome was changes in cognitive function, measured using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Outcomes were evaluated at baseline, within two weeks of the last program (post-intervention), and at the six-month follow-up session. Results The completion rate of the tablet-based program was 83.3% in patients with MCI. The program improved cognitive function based on the CERAD-K total score (p=0.026), which was maintained for at least three months (p=0.004). There was also an improvement in the depression scale score (p=0.002), which persisted for three months (p=0.027). Conclusions Our 12-week structured tablet-based program is feasible for patients with MCI. Furthermore, although further studies with a double-arm design are required, the program appears to be an effective strategy to prevent cognitive decline in patients with MCI.
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Affiliation(s)
| | | | | | - Yu Jeong Park
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Hoon Kang
- Geumcheon Center for Dementia, Seoul, Korea
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Kang DW, Wang SM, Um YH, Kim S, Kim T, Kim D, Lee CU, Lim HK. Impact of transcranial direct current stimulation on white matter microstructure integrity in mild cognitive impairment patients according to effect modifiers as risk factors for Alzheimer's disease. Front Aging Neurosci 2023; 15:1234086. [PMID: 37744398 PMCID: PMC10517264 DOI: 10.3389/fnagi.2023.1234086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background Little research exists on how individual risk factors for Alzheimer's disease (AD) affect the intermediate phenotype after transcranial direct current stimulation (tDCS), despite the importance of precision medicine-based therapeutic approaches. Objective To determine how an application of sequential tDCS (2 mA/day, left dorsolateral prefrontal cortex, 10 sessions) affects changes in white matter (WM) microstructure integrity in 63 mild cognitive impairment (MCI) patients with effect modifiers such as Aβ deposition, APOE ε4 carrier status, BDNF Val66Met polymorphism status, and sex. Methods We examined individual effect modifier-by-tDCS interactions and multiple effect modifiers-by-tDCS interactions for diffusion metrics. We also evaluated the association between baseline Aβ deposition and changes in WM microstructure integrity following tDCS. Results We found that APOE ε4 carrier status and sex had a significant interaction with tDCS, resulting in increased fractional anisotropy (FA) in the right uncinate fasciculus (UF) after stimulation. Additionally, we observed multiple effect modifiers-by-tDCS interactions on WM integrity of the right UF, leading to a more pronounced increase in FA values in APOE ε4 carriers and females with Val66 homozygotes. Finally, baseline Aβ deposition was positively associated with a difference in FA of the left cingulum in the hippocampal area, which showed a positive association with the changes in the score for delayed memory. Conclusion Our study shows the differential impact of individual AD risk factors on changes in the early intermediate phenotype after sequential tDCS in MCI patients. This research emphasizes the importance of precision medicine approaches in tDCS for the prodromal stages of AD.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - TaeYeong Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
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Achary MGT, Kaur R, Vibha D, Mani K, Kant S, Gupta SK. Mild Cognitive Impairment among Elderly Persons Residing in an Urban Resettlement Colony in Delhi. Indian J Community Med 2023; 48:721-726. [PMID: 37970150 PMCID: PMC10637611 DOI: 10.4103/ijcm.ijcm_8_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/18/2023] [Indexed: 11/17/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is a transitional state between normal cognition and clinical dementia. MCI is associated with an increased risk of dementia and mortality. Progression of MCI to dementia can be prevented by cognitive and lifestyle interventions. There is limited evidence on the burden and risk factors associated with MCI in India. To estimate the prevalence of MCI among elderly persons, and to study the factors associated with MCI. Materials and Methods This community-based cross-sectional study was carried out among 365 persons aged 60 years or older, residing in an urban resettlement colony of Delhi. Participants with dementia (score <23 on the Hindi version of the Mini-Mental State Examination) were excluded. Objective cognitive impairment and functional disability were assessed by the Montreal Cognitive Impairment-Basic (MoCA-B) tool and Barthel's Activities of Daily Living, respectively. The prevalence of MCI was estimated by Petersen's criteria, i.e., subjective memory impairment, objective cognitive impairment (MoCA score 19-25), functional independence, and absence of dementia. Univariate analysis was performed, followed by stepwise multivariate logistic regression. The association of socio-demographic and other health conditions with MCI was assessed. Results The prevalence of MCI was 9.3% [95% confidence interval (CI) 6.7-12.7], 13.3% (95% CI 8.8-19.7) among men, and 6.5% (95% CI 3.9-10.6) among women. The risk of MCI was higher among current smokers. Conclusions MCI was common among the elderly. Early detection of MCI may be included in health programs for elderly persons.
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Affiliation(s)
- MG Thejas Achary
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar Gupta
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Tulliani N, Bye R, Bissett M, Coutts S, Liu KPY. A Semantic-Based Cognitive Training Programme on Everyday Activities: A Feasibility and Acceptability Study among Cognitively Healthy Older Adults. Occup Ther Int 2023; 2023:2153223. [PMID: 37664163 PMCID: PMC10468288 DOI: 10.1155/2023/2153223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023] Open
Abstract
Background During the normal ageing process, a person's cognitive functions and memory gradually decline, which can affect their ability to perform everyday activities including cooking, cleaning, managing finances, and shopping. Semantic memory encoding strategies benefit older adults' cognitive and functional performance. Such strategies can be taught by an accessible, cost-effective, and flexible app-based programme. Currently, no studies examine such an app-based programme focussed on everyday activities. Objectives To determine if an app-based programme constructed on the principles of semantic memory encoding strategies, targeted towards older adults, called Enhancing Memory in Daily Life (E-MinD Life) is (1) feasible by examining acceptance, engagement, and attendance and (2) acceptable by examining the perceived effectiveness, relevancy, clarity, and convenience. Methods Eleven participants were recruited to a nine-week (18 sessions) programme using E-MinD Life. Feasibility was measured by collecting data on recruitment and retention rates, attendance, and duration of sessions. Acceptability was measured via a Likert scale questionnaire and free comments. Likert scale responses were analysed using descriptive statistics; open-ended responses were categorised qualitatively via constant comparative approach. Results Nine participants completed the programme. Overall, most participants found the programme relevant, convenient, logical, and easy to understand and perceived it to be effective to address functional cognitive problems impacting performance of everyday activities. The results from the qualitative analysis showed that participants found the programme enjoyable and the interaction with the research team throughout the intervention beneficial. Conclusion E-MinD Life shows promise as the focus of further research to determine the effectiveness of the programme and sematic-based cognitive strategies in maintaining cognition and performance in everyday activities among older adults with and without cognitive impairment.
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Affiliation(s)
- Nikki Tulliani
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Michelle Bissett
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Samantha Coutts
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Karen P. Y. Liu
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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Sorond FA, Gorelick PB. Brain Reserve, Resilience, and Cognitive Stimulation Across the Lifespan: How Do These Factors Influence Risk of Cognitive Impairment and the Dementias? Clin Geriatr Med 2023; 39:151-160. [PMID: 36404028 DOI: 10.1016/j.cger.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the absence of effective treatments for dementia, maintaining cognitive health in old age is one of the major challenges facing aging societies. Interventions for cognitive health that are tailored to the person are more likely to bring the best benefits with a minimum burden. We review the existing literature on this topic and discuss the role of the primary care physician.
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Affiliation(s)
- Farzaneh A Sorond
- Department of Neurology, Division of Stroke, Northwestern University, Feinberg School of Medicine, 625 North Michigan Avenue, 11th Floor, Chicago, IL 60611, USA.
| | - Philip B Gorelick
- Department of Neurology, Division of Stroke, Northwestern University, Feinberg School of Medicine, 625 North Michigan Avenue, 11th Floor, Chicago, IL 60611, USA
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13
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Gómez-Soria I, Iguacel I, Aguilar-Latorre A, Peralta-Marrupe P, Latorre E, Zaldívar JNC, Calatayud E. Cognitive stimulation and cognitive results in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 104:104807. [PMID: 36116285 DOI: 10.1016/j.archger.2022.104807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE The lack of cognitive activity accelerates age cognitive decline. Cognitive stimulation (CS) tries to enhance cognitive functioning. The purpose of this systematic review and meta-analysis was to evaluate the effects of CS on cognitive outcomes (general cognitive functioning and specific cognitive domains) in older adults (aged 65 years or older, cognitively healthy participants, or with mild cognitive impairment, or dementia). METHODS PubMed, Scopus and Web of Science databases were examined from inception to October 2021. A total of 1,997 studies were identified in these databases, and. 33 studies were finally included in the systematic review and the meta-analysis. Raw means and standard deviations were used for continuous outcomes. Publication bias was examined by Egger's Regression Test for Funnel Plot Asymmetry and the quality assessment tools from the National Institutes of Health. RESULTS CS significantly improves general cognitive functioning (mean difference=MD = 1.536, 95%CI, 0.832 to 2.240), memory (MD = 0.365, 95%CI, 0.300 to 0.430), orientation (MD = 0.428, 95%CI, 0.306 to 0.550), praxis (MD = 0.278, 95%CI, 0.094 to 0.462) and calculation (MD = 0.228, 95%CI, 0.112 to 0.343). CONCLUSION CS seems to increase general cognitive functioning, memory, orientation, praxis, and calculation in older adults.
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Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.
| | - Isabel Iguacel
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain.
| | | | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Eva Latorre
- Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan Nicolás Cuenca Zaldívar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain; Primary Health Center "El Abajon", 28231 Las Rozas de Madrid, Spain
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
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14
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Mraz H, Tong CY, Liu KPY. Semantic-based memory-encoding strategy and cognitive stimulation in enhancing cognitive function and daily task performance for older adults with mild cognitive impairment: A pilot non-randomised cluster controlled trial. PLoS One 2023; 18:e0283449. [PMID: 36972279 PMCID: PMC10042350 DOI: 10.1371/journal.pone.0283449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
AIM To investigate the effectiveness of a semantic-based memory-encoding strategy intervention and cognitive stimulation that enhances function for older adults with mild cognitive impairment. METHODS A two-armed single-blind non-randomised cluster controlled trial was conducted. Participants in two centres were allocated to the semantic-based memory-encoding experimental group and those in the other two centres received cognitive stimulation. In both groups, one centre- or community-based session and one home-based session were provided weekly for 10 weeks. Outcome measures included attention, memory and general cognitive function (Word List Memory and Word List Recall of the Consortium to Establish a Registry for the Alzheimer's disease, Digit Span Forwards and Backwards and the Cognistat), and daily task performance (Disability Assessment for Dementia and Lawton Instrumental Activities of Daily Living Scale). They were administered pre- and post-intervention. RESULTS Thirty-nine participants completed the study. No significant differences were revealed in the demographic or baseline data. The experimental group showed significant improvements in daily task performance (Disability Assessment for Dementia; p = 0.003), memory outcomes (Word List Recall; p < 0.001), general cognitive function (Cognistat subtests of Memory and Similarity; ps = 0.002 and < 0.001). The cognitive stimulation control group did not show any significant improvement in the measures. Between-group analysis showed significant differences in favour of the experimental group for the outcome measures of the Word List Recall and Cognistat Similarity subtest (ps < 0.001). CONCLUSIONS This study shows that the semantic-based memory-encoding strategy is more superior than cognitive stimulation with improvements in attention, memory, general cognitive function and daily task performance for people with a mild cognitive impairment. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration and Results System (NCT02953964).
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Affiliation(s)
- Hannah Mraz
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | | | - Karen P. Y. Liu
- School of Health Sciences, Western Sydney University, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- * E-mail:
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15
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Quialheiro A, Bobinski F, Haefliger JDG, Del Antonio R, Lins EF, Martins DF, d'Orsi E, Xavier AJ, Peres MA. A comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction can modify BDNF levels and improve cognition in adults over 50: a randomized controlled pilot study. Aging Ment Health 2022; 26:1979-1987. [PMID: 34405737 DOI: 10.1080/13607863.2021.1966742] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To analyze the effect of a comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction, called "Oficina da Lembrança" (OL), on the cognitive status and concentration of biomarkers of neuroplasticity, neurodegeneration in adults aged 50 years and over attending a Memory Clinic. METHODS In this pilot randomized controlled study, 64 patients without dementia aged 45 to 79 years, seen at a University Memory Clinic in Southern Brazil, were randomly allocated to the intervention and control groups. The intervention consisted of participation in OL for 12 weeks. Serum biomarkers (brain-derived neurotrophic factor [BDNF], S100β, and neuron-specific enolase [NSE]) and cognitive status were analyzed as primary and secondary outcomes. The Wilcoxon test and Generalized Estimating Equations (GEE) were applied. RESULTS Of the 64 patients invited to participate in the study, 33 (intervention: 17, control: 16) completed the study with all data. Improvement of cognitive status was significant in the intervention group (22.6 to 24.5) but not in the control group (20.1 to 21.1). There was a significant reduction of BDNF in OL participants, but no significant change was observed in the neurodegenerative biomarkers S100β or NSE. The concentration of BDNF decreased significantly post-OL in the intervention group (-288.1, 95%CI -362.1 to -94.1), even after adjusting for sex, age, and educational level. Cognitive status was significantly improved in OL participants. CONCLUSION The OL program improved cognitive status, reduced serum BDNF levels, and empowered digitally excluded older adults. There was no effect of this intervention on S100β or NSE. CLINICAL TRIAL REGISTRATION This study has a Universal Trial Number (UTN) U1111-1195-2642 and was registered in the Brazilian Clinical Trials Registry (ReBEC), number RBR-38X665.
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Affiliation(s)
- Anna Quialheiro
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.,Physiotherapy Course, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil.,Life and Health Sciences Research Institute (ICVS), Medicine School, University of Minho, Portugal
| | - Franciane Bobinski
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | | | - Renata Del Antonio
- Hospital of the Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - Elisa Flores Lins
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Daniel Fernandes Martins
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Eleonora d'Orsi
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - André Junqueira Xavier
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.,Medicine Course, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Marco Aurélio Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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16
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Tulliani N, Bissett M, Fahey P, Bye R, Liu KPY. Efficacy of cognitive remediation on activities of daily living in individuals with mild cognitive impairment or early-stage dementia: a systematic review and meta-analysis. Syst Rev 2022; 11:156. [PMID: 35918712 PMCID: PMC9344685 DOI: 10.1186/s13643-022-02032-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/17/2022] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Instrumental activities of daily living are essential for ageing well and independent living. Little is known about the effectiveness of cognitive remediation on instrumental activities of daily living performance for individuals with mild cognitive impairment or early-stage dementia. The objective of this study was to evaluate the immediate and long-term carryover effects of cognitive remediation on improving or maintaining instrumental activities of daily living performance in older adults with mild cognitive impairment and early-stage dementia. METHODS Randomized controlled trials published from 2009 to 2022 were identified in OvidSP versions of MEDLINE and Embase, EBSCO versions of CINAHL and PsycINFO, and the Cochrane Central Register of Controlled Trials. A narrative synthesis of the findings was reported on the outcomes of the included studies. Relevant data was extracted and analysed using R software's 'metafor' package with a random effect model with 95% CI. RESULTS Thirteen studies, totalling 1414 participants, were identified in the narrative analysis. The results of meta-analysis, inclusive of 11 studies, showed that cognitive remediation elicited a significant improvement in the instrumental activities of daily living performance (SMD: 0.17, 95% CI 0.03-0.31). There was insufficient evidence of any lasting effect. DISCUSSION Cognitive remediation is effective in improving instrumental activities of daily living performance immediately post-intervention in older adults with mild cognitive impairment and early-stage dementia. It appears that individualized interventions with a short duration, such as 10 hours, might be beneficial. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016042364.
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Affiliation(s)
- Nikki Tulliani
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Michelle Bissett
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia. .,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.
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17
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Jesus AG, de Lima MP, Vilar M, Pachana NA. Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial. Clin Gerontol 2022; 46:359-375. [PMID: 35916398 DOI: 10.1080/07317115.2022.2105670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology. METHODS Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index). RESULTS The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed. CONCLUSIONS Results provide evidence of the HEPPI's feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. CLINICAL IMPLICATIONS Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Australia
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18
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Lissek VJ, Ben Abdallah H, Praetorius A, Ohmann T, Suchan B. go4cognition: Combined Physiological and Cognitive Intervention in Mild Cognitive Impairment. J Alzheimers Dis 2022; 89:449-462. [DOI: 10.3233/jad-220145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: While cognitive interventions in mild cognitive impairment (MCI) show positive effects on cognitive performance, physical activity appear to slow down cognitive decline, suggesting a relationship between both factors. However, previous combined programs that have shown significant improvement in cognitive function in MCI have typically trained cognition and physical functioning separately. Objective: This project aimed at evaluating two group interventions combining the stimulation of physical and cognitive domains in individuals with MCI: Simultaneous stimulation of physical and cognitive skills in comparison to a standardized training, which stimulates cognitive and physical functions separately. Methods: The study was designed as a randomized controlled trial. The first group was trained on the SpeedCourt® system while the second group completed the standardized Fitfor100 program. Training was completed by a total of 39 subjects with diagnosed MCI as determined by the CERAD (SpeedCourt®: 24 subjects, Fitfor100:15 individuals). Results: There were significant improvements of physical factors (e.g., hand strength and balance) in both groups. Improvement in the CERAD total score allowed for a post interventional classification of all participants into non-MCI and MCI. This effect persisted over a period of three months. Both forms of intervention were found to be effective in improving various cognitive functions which persisted for a period of three months. Conclusion: Both evaluated non-pharmacological, multicomponent interventions, which combined physical and cognitive training in a social setting showed improvement of cognitive functions leading to a persistent classification of former MCI patients in non-MCI patients.
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Affiliation(s)
- Vanessa J. Lissek
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| | | | - Arthur Praetorius
- Department of Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg gGmbH, Duisburg, Germany
| | - Tobias Ohmann
- Research Department, BG Klinikum Duisburg gGmbH, Duisburg, Germany
| | - Boris Suchan
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
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19
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Poptsi E, Tsatali M, Agogiatou C, Bakoglidou E, Batsila G, Dellaporta D, Kounti-Zafeiropoulou F, Liapi D, Lysitsas K, Markou N, Mouzakidis C, Ouzouni F, Papasozomenou C, Soumpourou A, Vasiloglou M, Zafeiropoulos S, Tsolaki M. Longitudinal Cognitive and Physical Training Effectiveness in MCI, Based on the Experience of the Alzheimer's Hellas Day Care Centre. J Geriatr Psychiatry Neurol 2022; 35:512-526. [PMID: 34060355 DOI: 10.1177/08919887211016057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study assesses the effectiveness of a multicomponent Longitudinal Cognitive Training (CT) program plus physical exercise (PE) for people with Mild Cognitive Impairment (MCI). 155 people with MCI, completed a 3 years (3Y) CT+PE, whilst 133 were control. Neuropsychological assessment was performed at baseline and 3 years later, whilst CT+PE had additional annual assessments. According to the results, the 3Y CT+PE outperformed control in cognitive abilities (p < 0.002), and Activities of Daily Living (ADL) (p < 0.001), stabilized their functional performances between 1st and 2nd year, but worsened in working and verbal memory between 2nd and 3 rd year (p < 0.002). Control deteriorated in cognitive functions (p < 0.001) and ADL (p < 0.001) after 3 years, whilst 1.33% of the experimental and 13.53% of the control group progressed to dementia (p < 0.001). Longitudinal CT+PE improves cognitive performance and ADL in MCI and delay the progression to dementia.
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Affiliation(s)
- Eleni Poptsi
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,University of Sheffield International Faculty, City College, Thessaloniki, Greece
| | - Christina Agogiatou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Evaggelia Bakoglidou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Georgia Batsila
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Dionysia Dellaporta
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | | | - Despoina Liapi
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Konstantinos Lysitsas
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Nefeli Markou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Christos Mouzakidis
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Fani Ouzouni
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Chrysa Papasozomenou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Aikaterini Soumpourou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Maria Vasiloglou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Stavros Zafeiropoulos
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Thessaloniki, Greece
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20
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Lee KT, Wang WL, Lin WC, Yang YC, Tsai CL. The Effects of a Magic Intervention Program on Cognitive Function and Neurocognitive Performance in Elderly Individuals With Mild Cognitive Impairment. Front Aging Neurosci 2022; 14:854984. [PMID: 35493940 PMCID: PMC9045409 DOI: 10.3389/fnagi.2022.854984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Cognitive training is one of the management options for elderly individuals who suffer from mild cognitive impairment (MCI) and an effective way to improve executive function. This study aimed to evaluate the effectiveness of a magic intervention program as a method of cognitive training in improving cognitive function and neurocognitive performance in this group. Methods Twenty-four participants aged 60-80 years with MCI were recruited and randomly assigned to a magic intervention group or a control group. The magic intervention group received a 6-week magic intervention program. The primary endpoints were the scores for the cognitive assessment tests [e.g., Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)] for general cognitive function. The secondary endpoints were the behavioral [e.g., accuracy and reaction times] and the electroencephalographic [e.g., event-related potential (ERP) P3 amplitudes] performance during the Flanker task to assess attention and inhibitory control. All variables were measured before and after the magic intervention. Results The results showed that the 6-week magic intervention significantly improved the MoCA scores in the cognitive assessment tests although no significant pre-post intervention difference was observed in the MMSE scores. In terms of neurocognitive performance, the magic intervention had significantly positive effects on the accuracy, reaction times, and P3 amplitudes when performing the Flanker task. Conclusion The results of the present study showed that the 6-week magic intervention had beneficial effects on the cognitive and electrophysiological performance in the elderly subjects with MCI. For such a group, lifestyle intervention programs that encourage participation such as the magic practice and performance may be a viable suggestion to prevent the progression of MCI to Alzheimer's disease.
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Affiliation(s)
- Kuan-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan City, Taiwan
| | - Wei-Li Wang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan City, Taiwan
| | - Wen-Chin Lin
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan City, Taiwan
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21
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Amano T, Park S, Morrow-Howell N, Carpenter B. The Association Between Patterns of Social Engagement and Conversion From Mild Cognitive Impairment to Dementia: Evidence From the Health and Retirement Study. Alzheimer Dis Assoc Disord 2022; 36:7-14. [PMID: 34984994 DOI: 10.1097/wad.0000000000000486] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study examined the association between patterns of social engagement and conversion from cognitive impairment, no dementia (CIND) to dementia. It also tested whether social engagement is associated with conversion independently from physical and cognitive engagements. METHOD Data from 2 waves (2010 and 2014) of the Health and Retirement Study (HRS) were used. The sample consisted of 1227 people who had CIND in 2010. To identify the heterogeneity of social engagement, latent class analysis was utilized. Multinomial logistic regression analysis was utilized to investigate the association between patterns of social engagement and probability of conversion to dementia and death or dropout. RESULTS The result showed that patterns of social engagement that represent higher level and more variety of social engagement were associated with lower probabilities of conversion to dementia in 4 years but not with probabilities of death or dropout. The relationship held after controlling for physical and cognitive engagements. DISCUSSION Findings implied that promoting social engagement may be protective against developing dementia even for the high-risk group of people with CIND. Future studies should investigate the mechanism behind the relationship between patterns of social engagement and lower probabilities of conversion to dementia.
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Affiliation(s)
- Takashi Amano
- Department of Social Work, School of Arts and Sciences, Rutgers University-Newark, Newar, NJ
| | | | | | - Brian Carpenter
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO
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22
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Yuan M, Xiao X, Wang Y, Han Y, Zhang R, Fu H, Fang Y. Design and evaluation of a cognitive health education pilot program according to the RE-AIM framework. PLoS One 2021; 16:e0260934. [PMID: 34860851 PMCID: PMC8641877 DOI: 10.1371/journal.pone.0260934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 11/20/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Most formats of currently used community-based health education for cognitive impairment prevention are limited to one-way communication, such as distributing leaflets, pasting posters, or holding a lecture, and they lack comprehensive evaluation. Here we aim to design, test, and evaluate a novel pilot cognitive health education program combined with psychosocial interventions (CHECPI). METHODS We designed the CHECPI program and tested it among adults aged 60 and over in an aging-friendly community in 2018. Multidimensional cognitive functions were measured by the Montreal Cognitive Assessment (MoCA) before and three months after the CHECPI program. Quantitative and qualitative analyses were performed based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the program. Wilcoxon signed-rank tests were used to assess changes in multidimensional cognitive functions. RESULTS The CHECPI program was comprised of 12 courses and introduced 5 kinds of psychosocial interventions. Reach: 28 older adults participated in the program, of whom most were female (n = 22) and younger elderly with an average age of 65.32 years. Effectiveness: 19 participants finished≥6 courses as well as the follow-up survey. Although their MoCA scores did not improve significantly, they had increased their visuospatial ability significantly (with the average score increasing by 0.42). Adoption: the community officers, lecturers, and participants highly recommended the program, but they agreed that the lack of professional instructors may hinder its popularization. Implementation: the program was implemented in full accordance with the pre-program design. Maintenance: three months after the program, 17 participants had maintained at least one of the seven healthy behaviors that were introduced in the program. CONCLUSIONS Younger female elderly were more willing to participate in the program. It enhanced participants' visuospatial ability, but a sufficient number of professional instructors are crucial for large-scale promotion.
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Affiliation(s)
- Manqiong Yuan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Xiao Xiao
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Yifan Wang
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Yaofeng Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Rongmu Zhang
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Hanhan Fu
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
- * E-mail:
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Lee HM, Shin SW, Moon HS, Chung ST. Research trends in computerized cognitive training contents with text network. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-189985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Computerized Cognitive Training (CCT) contents used to improve patients’ cognitive ability with Mild Cognitive Impairment (MCI) can provide customized training through individual data collection and analysis. However, studies on transfer effect of improving other untrained cognitive domains while performing the contents are insufficient. The present paper intended to collect literature published by PubMed, EMBASE, Cochrane Library, and Web of Science until December 2019 and analyze the trends of CCT and the transfer effect in each training area. Studies on CCT (82/891) have been increasing each year, and universities (60/82) in the United States (17/82) have published the most. In the literature that reported clinical effect (18/82), the cognitive domain mostly studied was memory (14/18), and the N-Back (3/14) method accounted for most of the training contents. Moreover, the contents that showed the highest degree, closeness, and betweenness centrality (BC) indices were the memory area, and video accounted for the highest among the intervention methods. In particular, the closeness centrality (CC) index of the memory and attention contents showed similar results. It can be interpreted that the possibility of the transfer effect occurring from memory and attention areas is the highest since the semantic distance (i.e. the similarity of the training process) between the attention contents and memory contents was the closest. The effectiveness of the actual transfer effect between the memory and attention should be verified.
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Affiliation(s)
- Hyeok-Min Lee
- Department of IT Semiconductor Convergence, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
| | - Sung-Wook Shin
- Department of Computer Engineering, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
| | - Ho-Sang Moon
- Department of IT Semiconductor Convergence, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
| | - Sung-Taek Chung
- Department of Computer Engineering, Korea Polytechnic University, Siheung-si, Gyeonggi-do, Republic of Korea
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Chow G, Gan JKE, Chan JKY, Wu XV, Klainin-Yobas P. Effectiveness of psychosocial interventions among older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021; 25:1986-1997. [PMID: 33200623 DOI: 10.1080/13607863.2020.1839861] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This review aimed to examine available evidence concerning the effectiveness of psychosocial interventions in improving memory, executive function, depression and activities of daily living (ADL) in older adults with MCI. METHODS Eight electronic databases were used to conduct a comprehensive literature search for published and unpublished studies. A primary outcome was cognitive function, including memory and executive function. Secondary outcomes were depression and ADL. Two researchers independently appraised quality of included studies and extracted data. Meta-analysis, heterogeneity test, subgroup analysis and sensitivity analyses were performed. RESULTS Ten studies (out of 1,265 records) were included in this review. Psychosocial interventions contributed to a significant improvement in memory, not executive function, depression and ADL. Subgroup analyses suggested that interventions with a longer duration, more therapeutic sessions, and individual format had larger effect sizes. Strategies found to enhance memory entailed behavior modification and activation, memory training, visual imagery, storytelling, memory aids, journaling, and exercise. CONCLUSION Healthcare providers may offer psychosocial interventions to client with MCI in clinical settings. Higher quality trials should be conducted to increase solid evidence in this domain.
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Affiliation(s)
- Gigi Chow
- Khoo Teck Puat Hospital, Singapore, Singapore
| | | | | | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Level 2, Clinical Research Centre, National University of Singapore, Singapore, Singapore
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Kim Y, Chae M, Yang H. Simultaneous cognitive-physical dual task training based on fairy tales in older adults with mild cognitive impairment: A pilot study. Geriatr Nurs 2021; 42:1156-1163. [PMID: 34419868 DOI: 10.1016/j.gerinurse.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 12/29/2022]
Abstract
In this study, we aimed to develop a simultaneous cognitive-physical dual-task training program based on familiar cultural backgrounds using fairy tales and to explore its feasibility and preliminary effects, including effects on neurophysiological, cognitive, and physical functions. A single-group pretest-posttest design (n = 9) was employed to evaluate the effects of the cognitive-physical intervention performed for 60-90 min once a week for 12 weeks. The findings showed that perceived memory and physical self-efficacy, muscle strength, and cognitive function were significantly increased after the intervention. Although the relative beta band power measured using electroencephalography showed a tendency to increase in eight brain domains after the 12-week intervention, the changes were not significant. Findings suggested that the intervention was feasible and provided beneficial effects on cognitive and physical functions in older adults with mild cognitive impairment. Future research on larger sample sizes using randomized controlled trials is needed to determine the effectiveness of such interventions on neurophysiological functions.
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Affiliation(s)
- Younkyoung Kim
- Chonnam National University, College of Nursing, Gwangju, Republic of Korea
| | - Myeongjeong Chae
- Kwangju Women's University, Department of Nursing, Gwangju, Republic of Korea
| | - Hyunju Yang
- Chonnam National University, College of Nursing, Gwangju, Republic of Korea.
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Griffiths J, Thaikruea L, Wongpakaran N, Munkhetvit P, Kittisares A, Varnado P. Effects of Combined Physical Movement Activity and Multifaceted Cognitive Training in Older People with Mild Neurocognitive Disorder in a Rural Community: A Randomized Control Trial. Dement Geriatr Cogn Disord 2021; 49:194-201. [PMID: 32535601 DOI: 10.1159/000507922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/14/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cognitive deterioration in older people with mild neurocognitive disorders (mNCD) increases the risk of progress to major NCD. Health professionals worldwide are trying to find strategies for prevention. There is a limited number of studies that deal with cultural conditions in northern Thailand. OBJECTIVES This study aimed to investigate the effects of a combination of physical movement activity and multifaceted cognitive training on cognitive function in older people with mNCD. METHODS A randomized control trial involving 70 mNCD people, according to DSM-5 criteria, was conducted on an intervention group and a control group (n = 35 each). The program for the intervention group included 24 sessions (twice a week). The outcome measures on cognitive function were assessed before and after the intervention by means of composite cognitive measures for older people, i.e., the Trail-Making Test (TMT), Digit Span (DS), Verbal Fluency (VF), Word-List Learning (WLL), and Block Design (BD). RESULTS The combined intervention enhanced cognitive function. TMT-A was significantly improved in the intervention group. There were significant improvements in DS sequence scores, letter verbal fluency (LVF), and category verbal fluency (CVF). Comparing the groups, there were significant differences in LVF including immediate and delayed recall. BD improved significantly in the intervention group. CONCLUSIONS The combined intervention appeared to be effective in delaying/preventing cognitive deterioration and cognitive functional decline in people with mNCD. Further studies on a variation of treatments suited to cultural conditions and their effects are needed. Trials in other communities are also recommended.
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Affiliation(s)
- Jiranan Griffiths
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Lakkana Thaikruea
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Peeraya Munkhetvit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Adisak Kittisares
- Sriphat Medical Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pairada Varnado
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Kang DW, Wang SM, Kim TY, Kim D, Na HR, Kim NY, Lee CU, Lim HK. Impact of Transcranial Direct Current Stimulation on Cognitive Function, Brain Functional Segregation, and Integration in Patients with Mild Cognitive Impairment According to Amyloid-Beta Deposition and APOE ε4-Allele: A Pilot Study. Brain Sci 2021; 11:brainsci11060772. [PMID: 34200847 PMCID: PMC8230518 DOI: 10.3390/brainsci11060772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/03/2022] Open
Abstract
Anodal transcranial direct current stimulation (anodal-tDCS) is known to improve cognition and normalize abnormal network configuration during resting-state functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI). We aimed to evaluate the impact of sequential anodal-tDCS on cognitive functions, functional segregation, and integration parameters in patients with MCI, according to high-risk factors for Alzheimer’s disease (AD): amyloid-beta (Aβ) deposition and APOE ε4-allele status. In 32 patients with MCI ([18 F] flutemetamol-: n = 10, [18 F] flutemetamol+: n = 22; APOE ε4-: n = 13, APOE ε4+: n = 19), we delivered anodal-tDCS (2 mA/day, five times/week, for 2 weeks) over the left dorsolateral prefrontal cortex and assessed the neuropsychological test battery and resting-state fMRI measurements before and after 2 weeks stimulation. We observed a non-significant impact of an anodal-tDCS on changes in neuropsychological battery scores between MCI patients with and without high-risk factors of AD, Aβ retention and APOE ε4-allele. However, there was a significant difference in brain functional segregation and integration parameters between MCI patients with and without AD high-risk factors. We also found a significant effect of tDCS-by-APOE ε4-allele interaction on changes in the functional segregation parameter of the temporal pole. In addition, baseline Aβ deposition significantly associated negatively with change in global functional integrity of hippocampal formation. Anodal-tDCS might help to enhance restorative and compensatory intrinsic functional changes in MCI patients, modulated by the presence of Aβ retention and the APOE ε4-allele.
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Affiliation(s)
- Dong-Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (D.-W.K.); (C.-U.L.)
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (H.-R.N.)
| | - Tae-Yeong Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (T.-Y.K.); (D.K.)
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (T.-Y.K.); (D.K.)
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (H.-R.N.)
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Uiwang 16062, Korea;
| | - Chang-Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (D.-W.K.); (C.-U.L.)
| | - Hyun-Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (H.-R.N.)
- Correspondence:
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Bernini S, Panzarasa S, Barbieri M, Sinforiani E, Quaglini S, Tassorelli C, Bottiroli S. A double-blind randomized controlled trial of the efficacy of cognitive training delivered using two different methods in mild cognitive impairment in Parkinson's disease: preliminary report of benefits associated with the use of a computerized tool. Aging Clin Exp Res 2021; 33:1567-1575. [PMID: 32895890 DOI: 10.1007/s40520-020-01665-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/18/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The effectiveness of computer-based cognitive training (CCT) remains controversial, especially in older adults with neurodegenerative diseases. AIMS To evaluate the efficacy of CCT in patients with Parkinson's disease and mild cognitive impairment (PD-MCI). METHODS In this randomized controlled trial, 53 patients were randomized to receive CCT delivered by means of CoRe software, traditional paper-and-pencil cognitive training (PCT), or an unstructured activity intervention (CG). In each group, the intervention lasted 3 consecutive weeks (4 individual face-to-face sessions/week). Neuropsychological assessment was administered at baseline (T0) and post-intervention (T1). Outcome measures at T0 and T1 were compared within and between groups. The Montreal Overall Cognitive Assessment (MoCA) was taken as the primary outcome measure. RESULTS Unlike the PCT group and the CG, the patients receiving CCT showed significant medium/large effect size improvements in MoCA performance, global cognition, executive functions, and attention/processing speed. No baseline individual/demographic variables were associated with greater gains from the intervention, although a negative correlation with baseline MoCA performance was found. CONCLUSION CCT proved effective in PD-MCI patients when compared with traditional PCT. Further follow-up assessments are being conducted to verify the retention of the gains and the potential ability of the tool to delay conversion to PD-dementia. Trial registration number (ClinicalTrials.gov): NCT04111640 (30th September 2019).
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Affiliation(s)
| | - Silvia Panzarasa
- Dept. of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | | | | | - Silvana Quaglini
- Dept. of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- IRCCS Mondino Foundation, Pavia, Italy
- Dept. of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sara Bottiroli
- IRCCS Mondino Foundation, Pavia, Italy
- Giustino Fortunato University, Benevento, Italy
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McMurray J, Levy A, Holyoke P. Psychometric Evaluation and Workflow Integration Study of a Tablet-Based Tool to Detect Mild Cognitive Impairment in Older Adults: Protocol for a Mixed Methods Study. JMIR Res Protoc 2021; 10:e25520. [PMID: 34018966 PMCID: PMC8178737 DOI: 10.2196/25520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/16/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND With the rapid aging of the global population, experts anticipate a surge in the prevalence of mild cognitive impairment (MCI) and dementia worldwide. It is argued that developing more sensitive, easy to administer, and valid MCI screening tools for use in primary care settings may initiate timely clinical and personal care planning and treatment, enabling early access to programs and services. Including functional competence measures in screening tests makes them more ecologically valid and may help to identify cognitive deficits at an earlier stage. OBJECTIVE We aim to conduct a preliminary evaluative study comparing the sensitivity, specificity, and reliability of the BrainFx Screen (referred to as SCREEN hereafter), a novel digital tool designed to assess functional competence and detect early signs of cognitive impairment, with the Quick Mild Cognitive Impairment, a validated and highly sensitive tool that detects MCI in the older adult population. We will also investigate the perceived usefulness and integration of the SCREEN into primary care practice to identify demonstrable impacts on clinical workflow and health care providers' (HCP) perceptions of its success as a screening tool. Patients' perceptions of completing the SCREEN and its impact on their quality of life will also be explored. METHODS This study has a concurrent, mixed methods, prospective, and quasi-experimental design. Participants will be recruited from 5 primary care family health teams (FHTs; defined by multidisciplinary practice and capitated funding) across southwestern Ontario, Canada. Participants will include HCPs, patients, care partners, and FHT administrative executives. Patients 55 years and older with no history of diagnoses for MCI, dementia, or Alzheimer disease rostered in one of the FHTs participating in the study will be eligible to participate. Their care partners will help triangulate the qualitative data collected from patients. Participating FHTs will identify an occupational therapist from their site to participate in the study; this HCP will both administer the research protocol and participate in semistructured in-depth interviews and questionnaires. Principal component analysis will be conducted on the SCREEN data to understand the test components better. Tests comparing sensitivity, specificity, and test-retest reliability will assess the validity of SCREEN as a screening tool for MCI. RESULTS This paper describes the study protocol and its activities to date. Data collection was halted early because of COVID-19 restrictions on research activity, and data analysis is currently in progress. CONCLUSIONS At the end of the project, we anticipate having an initial comparative evaluation of the SCREEN as a tool for early detection of MCI in primary care older adult patient populations. Resource constraints on this research study limit our ability to conduct a randomized controlled trial; however, the results will assist developers of the SCREEN in determining whether rigorous controlled testing is warranted. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25520.
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Cintoli S, Radicchi C, Noale M, Maggi S, Meucci G, Tognoni G, Bonuccelli U, Sale A, Berardi N, Maffei L. Effects of combined training on neuropsychiatric symptoms and quality of life in patients with cognitive decline. Aging Clin Exp Res 2021; 33:1249-1257. [PMID: 31385203 DOI: 10.1007/s40520-019-01280-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/17/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Cognitive impairments associated with aging and dementia are major sources of neuropsychiatric symptoms (NPs) and deterioration in quality of life (QoL). Preventive measures to both reduce disease and improve QoL in those affected are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, NPs and QoL outcomes are too commonly overlooked in intervention trials. The purpose of this study was to test the effects of physical and cognitive training on NPs and QoL in MCI. METHODS Baseline data from an MCI court (N = 93, mean age 74.9 ± 4.7) enrolled in the Train the Brain (TtB) study were collected. Subjects were randomized in two groups: a group participated to a cognitive and physical training program, while the other sticked to usual standard care. Both groups underwent a follow-up re-evaluation after 7 months from baseline. NPs were assessed using the Neuropsychiatric Inventory (NPI) and QoL was assessed using Quality of Life-Alzheimer's Disease (QOL-AD) scale. RESULTS After 7 months of training, training group exhibited a significant reduction of NPs and a significant increase in QOL-AD with respect to no-training group (p = 0.0155, p = 0.0013, respectively). Our preliminary results suggest that a combined training can reduce NPs and improve QoL. CONCLUSIONS Measuring QoL outcomes is a potentially important factor in ensuring that a person with cognitive deficits can 'live well' with pathology. Future data from non-pharmacological interventions, with a larger sample and a longer follow-up period, could confirm the results and the possible implications for such prevention strategies for early cognitive decline.
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Affiliation(s)
- Simona Cintoli
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
- Department NEUROFARBA, University of Florence, Florence, Italy
| | - Claudia Radicchi
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Marianna Noale
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Stefania Maggi
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Giuseppe Meucci
- Department of Clinical Medicine, U.O.C. Neurology, Livorno, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Alessandro Sale
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
| | - Nicoletta Berardi
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy.
| | - Lamberto Maffei
- Institute of Neuroscience of the CNR, Via G. Moruzzi 1, 56100, Pisa, Italy
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Reynolds GO, Willment K, Gale SA. Mindfulness and Cognitive Training Interventions in Mild Cognitive Impairment: Impact on Cognition and Mood. Am J Med 2021; 134:444-455. [PMID: 33385339 DOI: 10.1016/j.amjmed.2020.10.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.
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Affiliation(s)
| | - Kim Willment
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Seth A Gale
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
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LIN FENGVANKEE, COTTONE KAYLIN, MCDERMOTT KELSEY, JACOBS ALANNA, NELSON DALLAS, PORSTEINSSON ANTON, CHAPMAN BENJAMINP. Attitudes Toward Computers Moderate the Effect of Computerized Cognitive Trainings in Oldest-Old Senior Living Center Residents. Am J Geriatr Psychiatry 2021; 29:285-294. [PMID: 32739240 PMCID: PMC9292062 DOI: 10.1016/j.jagp.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Computerized cognitive interventions (CCIs) have been increasingly implemented among older adults with mild cognitive impairment (MCI). However, older individuals' attitudes toward technology may limit CCI engagement. This exploratory-developmental study examined whether a "multi-functional interactive computer system" (MICS), which provides pleasurable activities via computer, would improve attitudes toward computers and in turn increase the efficacy of a subsequent CCI. RESEARCH DESIGN AND METHODS A phase one double-blind trial randomized 49 seniors with MCI to a MICS + CCI condition or a CCI-only condition. Attitudes toward technology use was assessed using The Attitudes Toward Computers Questionnaire (ATCQ), and cognition was assessed using episodic memory and executive function composite scores at baseline, the ends of MICS and CCI phases, and 3-month follow-up. RESULTS The MICS + CCI group did not show significantly greater improvement in cognition than the CCI only group. Secondary analyses indicated that improvement in executive function from baseline occurred in both groups. Participants who did show improved attitudes toward computers, whether through MICS or simply computer exposure itself, showed improvement in executive function. DISCUSSION AND IMPLICATION Participants in the MICS + CCI group used MICS less than expected. A more structured and supervised approach may be needed to facilitate MICS exposure. Improved attitudes toward computers regardless of MICS exposure may benefit candidates for CCI.
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Affiliation(s)
- FENG VANKEE LIN
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center,Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center,Department of Brain and Cognitive Sciences, University of Rochester,Department of Neuroscience, School of Medicine and Dentistry, University of Rochester Medical Center,Department of Neurology, School of Medicine and Dentistry, University of Rochester Medical Center
| | - KAYLIN COTTONE
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center
| | - KELSEY MCDERMOTT
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center
| | - ALANNA JACOBS
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center
| | - DALLAS NELSON
- Division of Geriatrics & Aging, Department of Medicine, School of Medicine and Dentistry, University of Rochester Medical Center
| | - ANTON PORSTEINSSON
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center,Department of Neurology, School of Medicine and Dentistry, University of Rochester Medical Center
| | - BENJAMIN P. CHAPMAN
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center,Department of Public Health, School of Medicine and Dentistry, University of Rochester Medical Center
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Kuan P, Clouston S, Yang X, Che C, Gandy S, Kotov R, Bromet E, Luft BJ. Single-cell transcriptomics analysis of mild cognitive impairment in World Trade Center disaster responders. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12154. [PMID: 33665344 PMCID: PMC7896635 DOI: 10.1002/dad2.12154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/16/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Recent research has found that World Trade Center (WTC) responders in their mid-50s have an elevated prevalence of mild cognitive impairment (MCI) that is associated with neural degeneration and subcortical thinning. This article extends our understanding of the molecular complexity of MCI through gene expression profiling of blood. METHODS The transcriptomics of 40 male WTC responders were profiled across two cohorts (discovery: nine MCI and nine controls; replication: 11 MCI and 11 controls) using CITE-Seq at single-cell resolution in blood. RESULTS Comparing the transcriptomic signatures across seven major cell subpopulations, the largest differences were observed in monocytes in which 226 genes were differentially expressed. Pathway analysis on the genes unique to monocytes identified processes associated with cerebral immune response. DISCUSSION Our findings suggested monocytes may constitute a key cell type to target in blood-based biomarker studies for early detection of risk of MCI and development of new interventions.
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Affiliation(s)
- Pei‐Fen Kuan
- Department of Applied Mathematics and StatisticsStony Brook UniversityStony BrookNew YorkUSA
| | - Sean Clouston
- Department of Family and Preventive MedicineStony Book UniversityStony BrookNew YorkUSA
| | - Xiaohua Yang
- Department of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Chang Che
- Department of Applied Mathematics and StatisticsStony Brook UniversityStony BrookNew YorkUSA
| | - Samuel Gandy
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Roman Kotov
- Department of PsychiatryStony Book UniversityStony BrookNew YorkUSA
| | - Evelyn Bromet
- Department of PsychiatryStony Book UniversityStony BrookNew YorkUSA
| | - Benjamin J. Luft
- Department of MedicineStony Brook UniversityStony BrookNew YorkUSA
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Efficacy of cognitive intervention programs in amnesic mild cognitive impairment: A systematic review. Arch Gerontol Geriatr 2021; 94:104332. [PMID: 33486120 DOI: 10.1016/j.archger.2020.104332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Amnesic mild cognitive impairment (aMCI) is considered a prodromal stage of Alzheimer's disease. Given the absence of an effective pharmacological treatment for aMCI, increasing numbers of studies are attempting to understand how cognitive interventions could benefit aMCI patients. The aim of this systematic review was to evaluate the current evidence regarding the efficacy on cognition of cognitive intervention programs in older adults with aMCI. METHODS We searched for randomized controlled trials and clinical trials published until March 2020 on PubMed, Web of Science, Cochrane Library, SCOPUS, and OTseeker. A total of 454 works were identified and 7 studies that met the inclusion criteria, were included in this review. PRISMA guidelines were followed and PEDro scale was included for the measurement of the quality of the selected studies. RESULTS Cognitive interventions showed positive effects on cognition. Cognitive training programs considerably enhanced the Mini Mental State Examination scores. However, no relevant differences in global cognition were found using other assessment tools as DRS-2 or ADAS-Cog Scale. Cognitive training and cognitive rehabilitation programs seemed to improve several cognitive domains as memory, language or executive function in aMCI patients in both post-training and at follow-up analysis. CONCLUSIONS Our findings support that cognitive interventions can be an effective option for people with aMCI. Cognitive interventions improved global cognitive function post-intervention, but also seemed to enhance some cognitive domains post-intervention and at follow-up. However, more studies are needed to analyze the potential benefits of cognitive intervention on aMCI.
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Preventing dementia? Interventional approaches in mild cognitive impairment. Neurosci Biobehav Rev 2021; 122:143-164. [PMID: 33440197 DOI: 10.1016/j.neubiorev.2020.12.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/13/2020] [Accepted: 12/19/2020] [Indexed: 12/19/2022]
Abstract
Mild cognitive impairment (MCI) is defined as an intermediate state between normal cognitive aging and dementia. It describes a status of the subjective impression of cognitive decline and objectively detectible memory impairment beyond normal age-related changes. Activities of daily living are not affected. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the well-being of people with MCI and their caregivers. Various forms and approaches of intervention for older people with MCI have been suggested to delay cognitive decline. Pharmacological as well as non-pharmacological approaches (cognitive, physiological, nutritional supplementation, electric stimulation, psychosocial therapeutic) and multicomponent interventions have been proposed. Interventional approaches in MCI from 2009 to April 2019 concerning the cognitive performance are presented in this review.
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Effects of expressive arts therapy in older adults with mild cognitive impairment: A pilot study. Geriatr Nurs 2021; 42:129-136. [DOI: 10.1016/j.gerinurse.2020.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022]
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Pike KE, Chong MS, Hume CH, Keech BJ, Konjarski M, Landolt KA, Leslie BE, Russo A, Thai C, Vilsten JS, Kinsella GJ. Providing Online Memory Interventions for Older Adults: A Critical Review and Recommendations for Development. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12339] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Mei San Chong
- School of Psychology and Public Health, La Trobe University,
| | | | | | | | | | | | - Adrian Russo
- School of Psychology and Public Health, La Trobe University,
| | - Christine Thai
- School of Psychology and Public Health, La Trobe University,
| | | | - Glynda Jane Kinsella
- School of Psychology and Public Health, La Trobe University,
- Department of Psychology, Caulfield Hospital,
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The Impact of a Twelve-Month Comprehensive Program of Cognitive Training for Alzheimer Patients: A Pilot Study. PSYCHIATRY INTERNATIONAL 2020. [DOI: 10.3390/psychiatryint1020010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Research has shown that non-pharmacological therapies can be useful in the treatment of Alzheimer’s disease (AD), significantly delaying cognitive decay. However, most AD interventions did not last beyond six months. Hence, little is known about the effect of these programs in the AD patients after six months of treatment. The purpose of this study was to evaluate the efficacy of the twelve-month Comprehensive Program of Cognitive Training (CPCT) for a sample of AD patients and to compare the results with the average annual rate of change. Thirty-nine AD patients participated in the study. The CPCT consists of a set of cognitive stimulations, intervention in activities of daily life (ADL), and motor training for 12 months. All patients were evaluated at baseline and in three-month intervals via the Mini Mental State Examination (MMSE), the Cambridge Cognitive Examination (CAMCOG), the Lawton Instrumental Activities of Daily Living Scale (IADL), and the Global Deterioration Scale (GDS). After CPCT implementation, there were no significant differences in the MMSE, IADL, and GDS evaluations between baseline and twelve months. Concerning the CAMCOG evaluation, there was no significant difference between the baseline and sixth-month assessments. Overall, the participants’ cognitive functioning did not decline when compared to the average annual rate of change. The CPCT extends the benefit of non-pharmacological interventions for AD patients to twelve months. Its implementation might provide the patients’ relatives with some guarantee concerning the delay of the disease. Future research may investigate the efficacy of the CPCT in comparison with a control group and over a more extended period.
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Sherman DS, Durbin KA, Ross DM. Meta-Analysis of Memory-Focused Training and Multidomain Interventions in Mild Cognitive Impairment. J Alzheimers Dis 2020; 76:399-421. [PMID: 32508325 DOI: 10.3233/jad-200261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Meta-analysis examining the efficacy of cognitive interventions on neuropsychological outcomes have suggested interventions that focus on memory may actually provide greater benefit against the cognitive declines associated with mild cognitive impairment (MCI). However, it remains unclear if memory-based training would be more effective at addressing the cognitive deficits associated with MCI than multidomain forms of intervention. OBJECTIVE A meta-analytic review and subgroup analysis was conducted to examine the effects of cognitive training in individuals diagnosed with MCI and to compare the efficacy of memory-based training with multidomain interventions. METHODS A total of 32 randomized controlled trials met inclusion criteria for the meta-analysis, which included 9 studies on memory-focused training and 17 studies on multidomain interventions. RESULTS We found significant, large effects for memory-focused training (Hedges' g observed = 0.947; 95% CI [-1.668, 3.562]; Z = 2.517; p = 0.012) and significant, moderate effects for multidomain interventions (Hedges' g observed = 0.420; 95% CI [-0.4491, 1.2891]; Z = 3.525; p < 0.001). A subgroup analysis found significant point estimates for memory-based forms of training and multidomain interventions, with memory-based forms of content yielding significantly greater summary effects than multidomain interventions (SMD Z = 2.162; p = 0.031, two-tailed; all outcomes). There was no difference between effect sizes when comparing outcomes limited to its respective domain. CONCLUSION Overall, these findings suggest that, while both interventions were beneficial, treatment interventions that were strictly memory-based were more effective at improving cognition in individuals diagnosed with MCI than interventions that targeted multiple cognitive domains.
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Affiliation(s)
- Dale S Sherman
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Rossier School of Education, University of Southern California, Los Angeles, CA, USA
| | - Kelly A Durbin
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - David M Ross
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychology, Loma Linda University, Loma Linda, CA, USA
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Lipardo DS, Tsang WW. Effects of combined physical and cognitive training on fall prevention and risk reduction in older persons with mild cognitive impairment: a randomized controlled study. Clin Rehabil 2020; 34:773-782. [PMID: 32380917 DOI: 10.1177/0269215520918352] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the effects of combined physical and cognitive training on fall rate and risks of falling in older adults with mild cognitive impairment. DESIGN The design of this study was an assessor-blinded, randomized controlled trial. SETTING The setting for this study is the community from Manila, Philippines. SUBJECTS In total, 92 community-dwelling older persons with mild cognitive impairment (aged 60-83) were randomly allocated to three intervention groups and one waitlist control group. INTERVENTIONS The physical training, cognitive training, and combined physical and cognitive training intervention programs were delivered for 60 to 90 minutes, one to three times per week for 12 weeks with six-month follow-up. MAIN MEASURES Participants were assessed at baseline, 12 weeks after baseline, and 36 weeks after baseline for fall incidence, overall fall risk, dynamic balance, walking speed, and lower limb strength. RESULTS No significant difference was observed across time and groups on fall incidence rate at 12 weeks (P = 0.152) and at 36 weeks (P = 0.954). The groups did not statistically differ in other measures except for a significant improvement in dynamic balance based on Timed Up and Go Test in the combined physical and cognitive training group (9.0 seconds with P = 0.001) and in the cognitive training alone group (8.6 seconds with P = 0.012) compared to waitlist group (11.1 seconds) at 36 weeks. CONCLUSION There was no significant difference among groups on fall rate and risks of falling post-intervention. Dynamic balance was improved with combined physical and cognitive training and cognitive training alone. Further research with a larger sample size is needed to establish whether or not the interventions are effective.
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Affiliation(s)
- Donald S Lipardo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - William Wn Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Department of Physiotherapy, School of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China
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Fusi G, Ferrari E, Zanetti M, Crepaldi M, Bersanini C, Paladino A, Colautti L, Rozzini L, Antonietti A, Rusconi ML. A Comparison of Divergent Thinking Abilities Between Healthy Elderly Subjects and MCI Patients: Preliminary Findings and Implications. Front Psychol 2020; 11:738. [PMID: 32425853 PMCID: PMC7204909 DOI: 10.3389/fpsyg.2020.00738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/26/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Divergent thinking (DT) has attracted research interest because of its potential role in early diagnosis and rehabilitation programs for patients affected by neurodegenerative diseases. Recently, DT has received even more attention because of its proven relationship with cognitive reserve (CR) and the possibility of a standardized assessment. However, few studies have investigated this ability in dementia patients, and even less is known about patients affected by Mild Cognitive Impairment (MCI). Thus, this study aims to investigate DT abilities in MCI patients. Methods A total of 25 MCI patients and 25 healthy controls subjects (HC; from a random selection of 50) matched for age, gender, and educational level were enrolled. General cognitive functioning was measured by the Montreal Cognitive Assessment (MoCA), while the Abbreviated Torrance Test for Adults (ATTA) was selected to measure DT. Results MANOVA analysis did not reveal any significant differences in DT abilities between MCI patients and HC except for the figural indicator score. A logistic hierarchical regression analysis revealed that the figural indicator score added an 8% of accuracy in the prediction of the group variable over the general cognition measure (MoCA). Conclusion MCI patients seem to perform significantly worse than HC only in the figural DT score and this evidence has significant practical implications. First, that figural DT seemed to decrease even earlier than verbal DT and could therefore be taken into account for early diagnosis of MCI patients. On the contrary, the sparing of all the other DT skills (such as verbal DT skills, fluency, flexibility, originality, and elaboration) may suggest that, given its relationship with CR, verbal DT could instead be considered a possible target for prevention or early cognitive stimulation interventions.
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Affiliation(s)
- Giulia Fusi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Elena Ferrari
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Marina Zanetti
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maura Crepaldi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Carol Bersanini
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Anna Paladino
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Laura Colautti
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Luca Rozzini
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Maria Luisa Rusconi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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Basak C, Qin S, O'Connell MA. Differential effects of cognitive training modules in healthy aging and mild cognitive impairment: A comprehensive meta-analysis of randomized controlled trials. Psychol Aging 2020; 35:220-249. [PMID: 32011155 DOI: 10.1037/pag0000442] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This meta-analysis was designed to compare the effectiveness of 2 cognitive training modules, single-component training, which targets 1 specific cognitive ability, versus multicomponent training, which trains multiple cognitive abilities, on both trained abilities (near transfer) and untrained abilities (far transfer) in older adults. The meta-analysis also assessed whether individual differences in mental status interacted with the extent of transfer. Eligible randomized controlled trials (215 training studies) examined the immediate effects of cognitive training in either healthy aging (HA) or mild cognitive impairment (MCI). Results yielded an overall net-gain effect size (g) for the cognitive training of 0.28 (p < .001). These effects were similar across mental status and training modules, and were significant for both near (g = 0.37) and far (g = 0.22) transfer. Although all training modules yielded significant near transfer, only a few yielded significant far transfer. Single-component training of executive functions was most effective on near and far transfer, with processing speed training improving everyday functioning. All modules of multicomponent training (specific and nonspecific) yielded significant near and far transfer, including everyday functioning. Training effects on cognition were moderated by educational attainment and number of cognitive outcomes, but only in HA. These findings suggest that, in older adults, all modules of multicomponent training are more effective in engendering near and far transfer, including everyday functioning, when compared with single-component training modules. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Chao ICI, Nicpon K, Roduta Roberts M. Effect of Cognitive Stimulation Therapy on Quality of Life: A Critical Review. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1716915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Iris C. I. Chao
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Katarzyna Nicpon
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Cognitive Improvement in Older Adults with Mild Cognitive Impairment: Evidence from a Multi-Strategic Metamemory Training. J Clin Med 2020; 9:jcm9020362. [PMID: 32013035 PMCID: PMC7074095 DOI: 10.3390/jcm9020362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/16/2020] [Accepted: 01/25/2020] [Indexed: 11/16/2022] Open
Abstract
Intervention programs to relieve memory impairment and memory-related complaints in older adults with mild cognitive impairment are needed. Objective: The purpose of the current study was to assess the efficacy of a novel cognitive training approach-named multi-strategic metamemory training-in older adults with amnestic mild cognitive impairment. Among a total of 113 older adults with mild cognitive impairment, 66 participated in the memory training program (training group) and 47 did not (control group). Repeated measures of analysis of variance revealed that compared with the control group, the training group experienced: i) a significantly greater increase in cognitive test scores of long-term delayed free recall (Finteraction = 6.04, p = .016) and fluency (Finteraction = 4.11, p = .045) and ii) significantly greater decrease in their subjective memory complaints for everyday memory (Finteraction = 7.35, p = .009). These results suggest that the training program can improve verbal memory (i.e., delayed free recall), language processing (i.e., categorical fluency) and limit complaints in everyday instrumental memory activities of mildly impaired older adults.
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Integrating Working Memory Exercises With Nursing Home Rehabilitation to Achieve “Better, Faster” Functional Outcomes. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abdo JS, Mendes ARM, Alencar MA, Gomes GDC. Influência da escolaridade de idosas nos ganhos de função executiva após treino de dupla tarefa. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.200088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Investigar a influência da escolaridade nos ganhos de função executiva após o treinamento com dupla tarefa (DT). Método Estudo exploratório realizado com 31 idosas, com escolaridade ≥3 anos e sem alterações das funções cognitivas rastreadas pelo Miniexame do Estado Mental (MEEM). As participantes foram distribuídas em dois grupos a partir do critério escolaridade, sendo o Grupo 1 com escolaridade de três a sete anos (n=17) e o Grupo 2 com escolaridade igual e superior a oito anos (n=14). Foram avaliadas as funções executivas antes e após o treinamento através dos testes Stroop, Exame Cognitivo de Addenbrooke - Revisado (ACE-R) e Trilhas B. O protocolo de intervenção consistiu em três sessões semanais, duração de 50 minutos cada, com a realização de atividades de DT cognitiva e motora, associadas à caminhada, por 12 semanas. Resultados A ANOVA indicou que o treinamento de DT melhorou significativamente o desempenho nos testes Stroop (F=5,95; p=0,02) e ACE-R (F=18,33; p<0,0001), independentemente da escolaridade. Foi verificado efeito do grupo nos testes ACE-R (F=14,65; p<0,001) e Trilhas B (F=18,74; p<0,001). Em nenhum dos testes analisados, foi observado efeito da interação grupo x tempo (0,04<F<2,14; 0,15<p<0,95). Conclusão O treinamento de DT pode melhorar significativamente a função executiva de idosas, independente do nível de escolaridade, podendo ser utilizado na prática clínica como uma proposta de intervenção, visando o ganho de função executiva.
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Four-Week, Home-Based, Robot Cognitive Intervention for Patients with Mild Cognitive Impairment: a Pilot Randomized Controlled Trial. Dement Neurocogn Disord 2020; 19:96-107. [PMID: 32985149 PMCID: PMC7521954 DOI: 10.12779/dnd.2020.19.3.96] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022] Open
Abstract
Background and Purpose Previous studies suggest that cognitive intervention can mitigate the development of dementia in patients with mild cognitive impairment (MCI). However, the previous cognitive intervention was mostly provided as a group session, in which MCI patients sometimes had difficulty in regularly attending sessions or were reluctant to participate in group-based classes. Additionally, experienced instructors for traditional cognitive intervention may be unavailable in some chronic-care facilities or community centers. Considering these reasons, we have developed 5 programs for home-based cognitive intervention using a personal robot for MCI patients. In this preliminary study, we aimed to demonstrate the effects of our newly developed home-based cognitive intervention with robots on cognitive function in MCI patients. Methods We conducted a single-blind randomized controlled trial enrolling 46 MCI patients. Participants were randomized into 2 groups: the robot cognitive intervention (robot) (n=24) group and without cognitive intervention (control) (n=22) group. The interventions comprised 60-min sessions per day for 4 weeks. The primary outcome was the change in cognitive function measured using the Cambridge Neuropsychological Test Automated Battery. Results There were no significant baseline demographic or clinical differences between the robot and control groups. After the 4-week cognitive intervention, the robot group showed greater improvement in working memory than did the control group. Conclusions Our home-based cognitive intervention with a personal robot improved the working memory in MCI patients. Further studies with larger samples and longer study periods are required to demonstrate the effects of these programs in other cognitive domains in MCI patients.
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Nousia A, Martzoukou M, Siokas V, Aretouli E, Aloizou AM, Folia V, Peristeri E, Messinis L, Nasios G, Dardiotis E. Beneficial effect of computer-based multidomain cognitive training in patients with mild cognitive impairment. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:717-726. [DOI: 10.1080/23279095.2019.1692842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Anastasia Nousia
- Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece
| | - Maria Martzoukou
- Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Eleni Aretouli
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Vasiliki Folia
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Eleni Peristeri
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Lambros Messinis
- Neuropsychology Section, Department of Neurology, University of Patras Medical School, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Meade ME, Ahmad M, Fernandes MA. Drawing pictures at encoding enhances memory in healthy older adults and in individuals with probable dementia. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:880-901. [PMID: 31833456 DOI: 10.1080/13825585.2019.1700899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We explored the efficacy of drawing pictures as an encoding strategy to enhance memory performance in healthy older adults and individuals with probable dementia. In an incidental encoding phase, participants were asked to either draw a picture or write out each word from a set of 30 common nouns for 40 seconds each. Episodic memory for the target words was compared in a group of healthy older adults to individuals with probable dementia (MMSE/MOCA range 4 to 25). In two experiments we showed that recall and recognition performance was higher for words that were drawn than written out during encoding, for both participant groups. We suggest that incorporating visuo-perceptual information into memory enhanced performance by increasing reliance on visual-sensory brain regions, which are relatively intact in these populations. Our findings demonstrate that drawing is a valuable technique leading to measurable gains in memory performance for individuals with probable dementia.
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Affiliation(s)
- Melissa E Meade
- Department of Psychology, University of Waterloo , Waterloo, Canada
| | - Maahum Ahmad
- Department of Psychology, University of Waterloo , Waterloo, Canada
| | - Myra A Fernandes
- Department of Psychology, University of Waterloo , Waterloo, Canada
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He W, Wang M, Jiang L, Li M, Han X. Cognitive interventions for mild cognitive impairment and dementia: An overview of systematic reviews. Complement Ther Med 2019; 47:102199. [PMID: 31780033 DOI: 10.1016/j.ctim.2019.102199] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/20/2019] [Accepted: 09/22/2019] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Conducting an overview of systematic reviews (SRs)/Meta analyses (MAs) to assess the effectiveness of cognitive interventions on participants with mild cognitive impairment (MCI) or dementia and evaluate the methodological quality of SRs/MAs. METHODS PubMed, EMBASE, Cochrane library, Web of science, China National Knowledge Infrastructure (CNKI) and Chinese Biomedical Databases (CBM) were systematically searched from inception to January 1, 2019 to identify SRs/MAs. Three reviewers independently screened the articles, extracted data and assessed the quality of the included studies according to the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Grading of Recommendations Assessment Development and Evaluation (GRADE) was used to evaluate the quality of evidence. RESULTS A total of 22 reviews were included. New meta-analyses (36 RCTs) showed that cognitive interventions were more effective than routine therapies for the alleviation of MCI and dementia symptoms (SMD: 0.62; 95%CI: 0.47, 0.78; I2 = 53.9%). The results of AMSTAR-2 showed that the methodological quality of most included studies was critically low, and two reviews were low quality. The lowest score was item 10, none of reviews reported on the sources of funding for the included studies. Followed by the "provide a list of excluded studies and justify the exclusions" item with only one (4.5%) reviews conforming to this item. Results of GRADE manifested that moderate quality evidence was provided in 11 reviews (39.3%), 12 (42.9%) were low quality and 5 (17.8%) were very low. CONCLUSION The present SRs/MAs indicated that persons with MCI or dementia could benefit from cognitive interventions. Future trial designs should focus on measuring changes in individual specific cognitive functions. More high-quality evidence is needed to further determine the effectiveness of cognitive interventions.
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Affiliation(s)
- Wenbo He
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Meng Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Lili Jiang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Meixuan Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou, 730000, China
| | - Xuemei Han
- School of Public Health, Lanzhou University, Lanzhou, 730000, China.
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