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Martínez-Carrasco C, Cid-Navarrete F, Rossel PO, Fuentes J, Zamunér AR, Méndez-Rebolledo G, Cabrera-Aguilera I. Relationship Between Executive Function Subdomains and Postural Balance in Community-Dwelling Older Adults. J Aging Phys Act 2024:1-9. [PMID: 39089679 DOI: 10.1123/japa.2023-0323] [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: 09/20/2023] [Revised: 04/04/2024] [Accepted: 05/13/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Executive function (EF) deficits are a significant risk factor for falls among older adults (OAs). However, relationship between EF subdomains (shifting, updating, and inhibition), postural balance (PB), and fall risk in healthy OAs, remains poorly understood. OBJECTIVE This study aimed to investigate the relationship between EF subdomains (shifting, updating, and inhibition) and PB, and to assess their impact on risk of falls in community-dwelling OAs. METHODS A cross-sectional study involving 50 OAs aged over 60 years (average age of 72 years) was conducted. Participants underwent assessments of EF subdomains and PB using validated tests. A correlation analysis was employed to examine the relationships between EF and PB. RESULTS The study revealed significant correlations between subdomains and PB. Mental set shifting (r = -.539; p < .001) and inhibition (r = -.395; p = .050) exhibited inverse relationships with PB. Stepwise multiple linear regression showed that Trail Making Test Part B was associated with the PB (R2 = .42, p < .001). CONCLUSION These findings highlight the importance of assessing EF subdomains, particularly shifting and inhibition, to identify risk of falls. Trail Making Test Part B largely explains the variability of the PB. Integrating PB assessments and EF training, such as the Mini-BESTest, into routine care can be vital for fall prevention strategies. Significance/Implications: This knowledge underscores the need for cognitive training interventions focusing on shifting and inhibition to enhance PB and potentially reduce falls. Additionally, incorporation of EF assessment tools as Trail Making Test Part B and the Mini-BESTest into routine clinical practice for community-dwelling OAs is recommended to address fall prevention strategies.
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Affiliation(s)
- Claudia Martínez-Carrasco
- Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Concepción, Chile
| | | | - Pedro O Rossel
- Departamento de Ingeniería Informática, Universidad Católica de la Santísima Concepción, Concepción, Chile
- Centro de Investigación en Biodiversidad y Ambientes Sustentables (CIBAS), Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Jorge Fuentes
- Clinical Research Lab, Department of Physical Therapy, Universidad Católica del Maule, Talca, Chile
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AL, Canada
| | - Antonio Roberto Zamunér
- Clinical Research Lab, Department of Physical Therapy, Universidad Católica del Maule, Talca, Chile
| | - Guillermo Méndez-Rebolledo
- Laboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Ignacio Cabrera-Aguilera
- Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Concepción, Chile
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Smith LJ, Wilkinson D, Bodani M, Surenthiran SS. Cognition in vestibular disorders: state of the field, challenges, and priorities for the future. Front Neurol 2024; 15:1159174. [PMID: 38304077 PMCID: PMC10830645 DOI: 10.3389/fneur.2024.1159174] [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: 02/05/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Vestibular disorders are prevalent and debilitating conditions of the inner ear and brain which affect balance, coordination, and the integration of multisensory inputs. A growing body of research has linked vestibular disorders to cognitive problems, most notably attention, visuospatial perception, spatial memory, and executive function. However, the mechanistic bases of these cognitive sequelae remain poorly defined, and there is a gap between our theoretical understanding of vestibular cognitive dysfunction, and how best to identify and manage this within clinical practice. This article takes stock of these shortcomings and provides recommendations and priorities for healthcare professionals who assess and treat vestibular disorders, and for researchers developing cognitive models and rehabilitation interventions. We highlight the importance of multidisciplinary collaboration for developing and evaluating clinically relevant theoretical models of vestibular cognition, to advance research and treatment.
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Affiliation(s)
- Laura J. Smith
- Centre for Preventative Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
| | - David Wilkinson
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
| | - Mayur Bodani
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
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Phillips CB, McVey A, Tian J, Stephan AT, Davis WB, Aflagah EL, Ross LA. Feasibility of a pilot dyadic randomized controlled trial testing the effects of three behavioral interventions on older adults' cognitive, physical and everyday function. FRONTIERS IN AGING 2023; 4:1166338. [PMID: 37305226 PMCID: PMC10248235 DOI: 10.3389/fragi.2023.1166338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023]
Abstract
Introduction: Maintaining functional abilities is critical for optimizing older adults' well-being and independence. This randomized controlled trial (RCT) pilot examined the feasibility of testing the effects of three commercially available interventions on function-related outcomes in older adults. Methods: Pairs of community-dwelling older adults (N=55, Mage=71.4) were randomized to a 10-week intervention (cognitive-COG, physical-EX, combined exergame-EXCOG, or control-CON). Cognitive, physical, and everyday function were assessed at baseline, immediately post-intervention, and 6-months post-intervention. Feasibility was evaluated using recruitment, enrollment, training adherence, and retention metrics. Variability and patterns of change in functional outcomes were examined descriptively. Results: A total of 208 individuals were screened, with 26% subsequently randomized. Across training arms, 95% of training sessions were completed and 89% of participants were retained at immediate post-test. Variability in functional outcomes and patterns of change differed across study arms. Discussion: Results support a fully powered RCT, with several modifications to the pilot study design, to investigate short- and long-term training impacts.
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Affiliation(s)
- Christine B. Phillips
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - Ava McVey
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - Junyan Tian
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, United States
| | - Abigail T. Stephan
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
| | - W. Bennett Davis
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Erica L. Aflagah
- Department of Neurology, Neuropsychology Division, University of Nebraska Medical Center, Omaha, NE, United States
| | - Lesley A. Ross
- Department of Psychology, Clemson University, Clemson, SC, United States
- Clemson University Institute for Engaged Aging, Seneca, SC, United States
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Sprague BN, Ross LA, Ball KK. Does Cognitive Training Reduce Falls across Ten Years?: Data from the ACTIVE Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4941. [PMID: 36981850 PMCID: PMC10048914 DOI: 10.3390/ijerph20064941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to examine the effect of cognitive training on the risk of experiencing a fall across 10 years. The study used data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial. Older adults aged 65-94 were randomly assigned to speed of processing, memory, or reasoning training or to a no-contact control group (n = 2802). The experience of a fall in the prior two months was assessed at baseline and at 1, 2, 3, 5, and 10 years posttest. Cox proportional hazards explored group differences in the total sample, as well as group differences for participants classified as low risk (n = 2360) and high risk (n = 442) for future falls. The data were censored at the first reported fall postbaseline. After baseline, 983 (35.08%) participants across the full sample reported a fall. There were no significant effects of the training in the full sample or in the low-risk sample of participants. However, the participants at greater risk for future falls in the speed of processing training group were 31% less likely (HR = 0.69; 95% CI = 0.48, 0.998, p = 0.049) to experience a subsequent fall across ten years compared to the control group. Reasoning and memory training did not reduce a future fall in the high-risk sample. The speed of processing training reduced the risk of future falls across ten years in the high-risk participants. Future work should examine moderators and mediators of training in at-risk samples.
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Affiliation(s)
- Briana N. Sprague
- Division of General Internal Medicine & Geriatrics, University of Indiana School of Medicine, Indianapolis, IN 46202, USA
- Center for Aging Research, Regenstrief Institute, Indianapolis, IN 46202, USA
| | - Lesley A. Ross
- Department of Psychology, Clemson University, Clemson, SC 29634, USA
| | - Karlene K. Ball
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
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Effect of Exercise Cognitive Combined Training on Physical Function in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2023; 31:155-170. [PMID: 35961648 DOI: 10.1123/japa.2021-0475] [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: 12/06/2021] [Revised: 04/20/2022] [Accepted: 06/04/2022] [Indexed: 02/03/2023]
Abstract
This study aimed to evaluate the effects of exercise cognitive combined training (ECCT) compared with non-ECCT on physical function in cognitively healthy older adults. Databases were searched for randomized controlled trials from inception to December 2, 2021, and 22 studies (1,091 participants, Mage = 74.90) were included in the meta-review. The Cochrane Risk of Bias and Grading of Recommendations Assessment, Development, and Evaluation tools were used for quality assessments. ECCT improved gait speed (mean difference: 0.06 m/s, 95% CI [confidence interval] [0.02, 0.11]; 446 participants, 11 studies) and balance (standardized mean difference: 0.38, 95% CI [0.14, 0.61]; 292 participants, seven studies). Simultaneous ECCT, but not nonsimultaneous ECCT, improved gait speed (mean difference: 0.11 m/s, 95% CI [0.07, 0.15]), balance (standardized mean difference: 0.40, 95% CI [0.16, 0.64]), and functional mobility (mean difference: -0.85 s, 95% CI [-1.63, -0.07]; 327 participants, nine studies). Future research should focus on the duration and form of ECCT intervention optimal for improving the functional activities of older individuals.
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da Silva TBL, Bratkauskas JS, Barbosa MEDC, da Silva GA, Zumkeller MG, de Moraes LC, Lessa PP, Cardoso NP, Ordonez TN, Brucki SMD. Long-term studies in cognitive training for older adults: a systematic review. Dement Neuropsychol 2022; 16:135-152. [PMID: 35720648 PMCID: PMC9173785 DOI: 10.1590/1980-5764-dn-2021-0064] [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: 06/29/2021] [Revised: 10/25/2021] [Accepted: 10/30/2021] [Indexed: 11/22/2022] Open
Abstract
Studies show that aging is accompanied by losses in cognitive functions and that interventions can increase performance and/or support the maintenance of cognitive skills in the elderly.
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Affiliation(s)
- Thais Bento Lima da Silva
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brazil.,Instituto Supera de Educação, São José dos Campos SP, Brazil
| | | | | | | | | | | | | | | | | | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brazil
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Mendes L, Oliveira J, Barbosa F, Castelo-Branco M. A Conceptual View of Cognitive Intervention in Older Adults With and Without Cognitive Decline-A Systemic Review. FRONTIERS IN AGING 2022; 3:844725. [PMID: 35821828 PMCID: PMC9261456 DOI: 10.3389/fragi.2022.844725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
Background: Dementia is the one of the most common and prominent disease in the elderly person that results in the Cognitive interventions. In this study, we aim to conceptualize the cognitive intervention for older adults with and without cognitive dysfunction and to clarify the heterogeneity existing in this literature field by determining the main variables implicated. Methods: We conducted a study analysis using previous literature highlighting the significant data reporting empirical results from cognitive intervention for healthy older adults and other seniors with different types of dementia. Each paper was reviewed in terms of compensatory cognitive training, cognitive remediation, enrichment, cognitive activation, brain training, cognitive stimulation, cognitive training, and cognitive rehabilitation. The research analysis was performed following rigorous inclusion and exclusion criteria with the purpose of collecting relevant answers to our research questions. Results: We included a total of 168 studies in our review. Our findings indicated heterogeneity regarding methods, concepts, and procedures. Additionally, the values were integrated using different information existing in this field. Conclusion: In conclusion, we highlighted that this is the first review that clarify the discrepancy of various existing definitions, methods, and procedures, as well as the overlapping information in the cognitive interventions.
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Affiliation(s)
- Liliana Mendes
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joana Oliveira
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Fernando Barbosa
- Faculty of Psychology and Education Science, University of Porto, Porto, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Hardcastle C, Hausman HK, Kraft JN, Albizu A, Evangelista ND, Boutzoukas EM, O'Shea A, Langer K, Van Van Etten E, Bharadwaj PK, Song H, Smith SG, Porges E, DeKosky ST, Hishaw GA, Wu SS, Marsiske M, Cohen R, Alexander GE, Woods AJ. Higher-order resting state network association with the useful field of view task in older adults. GeroScience 2022; 44:131-145. [PMID: 34431043 PMCID: PMC8810967 DOI: 10.1007/s11357-021-00441-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022] Open
Abstract
Speed-of-processing abilities decline with age yet are important in performing instrumental activities of daily living. The useful field of view, or Double Decision task, assesses speed-of-processing and divided attention. Performance on this task is related to attention, executive functioning, and visual processing abilities in older adults, and poorer performance predicts more motor vehicle accidents in the elderly. Cognitive training in this task reduces risk of dementia. Structural and functional neural correlates of this task suggest that higher-order resting state networks may be associated with performance on the Double Decision task, although this has never been explored. This study aimed to assess the association of within-network connectivity of the default mode network, dorsal attention network, frontoparietal control network, and cingulo-opercular network with Double Decision task performance, and subcomponents of this task in a sample of 267 healthy older adults. Multiple linear regressions showed that connectivity of the cingulo-opercular network is associated with visual speed-of-processing and divided attention subcomponents of the Double Decision task. Cingulo-opercular network and frontoparietal control network connectivity is associated with Double Decision task performance. Stronger connectivity is related to better performance in all cases. These findings confirm the unique role of the cingulo-opercular network in visual attention and sustained divided attention. Frontoparietal control network connectivity, in addition to cingulo-opercular network connectivity, is related to Double Decision task performance, a task implicated in reduced dementia risk. Future research should explore the role these higher-order networks play in reduced dementia risk after cognitive intervention using the Double Decision task.
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Affiliation(s)
- Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Kailey Langer
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Emily Van Van Etten
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Steven T DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
- Department of Neuroscience, University of Florida, Gainesville, FL, USA.
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10
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Dynamic Useful Field of View Training to Enhance Older Adults’ Cognitive and Motor Function: a Pilot Study. JOURNAL OF COGNITIVE ENHANCEMENT 2021; 5:411-419. [DOI: 10.1007/s41465-021-00219-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sprague BN, Phillips CB, Ross LA. Cognitive Training Attenuates Decline in Physical Function Across 10 Years. J Gerontol B Psychol Sci Soc Sci 2021; 76:1114-1124. [PMID: 32484891 DOI: 10.1093/geronb/gbaa072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Poor physical function is associated with negative health and cognitive outcomes. Although nine studies demonstrated that cognitive training reduces age-related declines in physical function, only one study has examined the effects beyond immediate posttest changes. The first aim of this study was to assess the impact of three cognitive training programs on physical function measures across 10 years and the second aim was to examine whether baseline cognitive self-efficacy or depressive symptoms moderated training effects. METHOD Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial, older adults in a no-contact control condition (n = 698) were compared to those receiving processing speed (n = 702), memory (n = 703), or reasoning (n = 694) training. Intention-to-treat (ITT) and dosage analyses were conducted for grip strength and Turn 360. Participants were followed up to 10 years posttest. RESULTS There were no significant ITT effects of processing speed, memory, or reasoning training assignment to any physical function outcome (p > .05). Dosage models indicated that there were small age-related attenuation effects in Turn 360 decline with more processing speed training (b = -.011, p < .001), memory training (b = -.011, p < .001), and reasoning training (b = -.012, p < .001). There was no significant transfer to grip strength. These training gains were greater for those with more baseline depressive symptoms who received more processing speed training (b = -.001, p < .001). DISCUSSION This is the first study to demonstrate the effects of cognitive training to complex physical function across 10 years.
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Affiliation(s)
- Briana N Sprague
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | | | - Lesley A Ross
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park.,Department of Psychology, Clemson University, South Carolina
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Zhao X, Wang L, Ge C, Liu X, Chen M, Zhang C. Effect of Process-Based Multi-Task Cognitive Training Program on Executive Function in Older Adults With Mild Cognitive Impairment: Study Rationale and Protocol Design for a Randomized Controlled Trial. Front Psychiatry 2020; 11:655. [PMID: 32848901 PMCID: PMC7396621 DOI: 10.3389/fpsyt.2020.00655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Recent research from both human and animal studies confirms that cognitive training gains a considerable effect on multiple cognitive domains in older adults with mild cognitive impairment. Previous studies have yet paid scant attention to executive function training. Little is known about whether this specific benefit translates to maintaining long-term effectiveness and transfer effects are. This study is designed as an effort to address this issue. OBJECTIVE The program aimed to evaluate the effect of process-based multi-task cognitive training on executive function and further explore its long-term effects and transfer effects in older adults with MCI. Furthermore, we will explore the neural correlates latent the changed performances underlying the cognitive intervention. METHODS This program is a single-blinded, randomized, prospective clinical trial to test the effect of process-based multi-task cognitive training in older adults with MCI. Ninety participants with MCI will be recruited and randomly assigned to the cognitive training group (n=45) and the wait-list control group (n=45). The cognitive training group will receive 10 weeks of process-based multi-task cognitive training and health education twice a week, at 40~60 min per session. While the wait-list control group will only receive 10 weeks of health education during the research period. The effect is measured using the executive function, neuropsychological assessment performance and related brain activity assessed with electroencephalogram parameters (slowness and complexity of the EEG) at baseline, after 10 weeks of training, and a 3-month follow-up. RESULTS The study is currently ongoing. Recruitment began in March 2019 and will conclude at the end of 2020. Effects of the process-based multi-task cognitive training on executive function in older adults with MCI will be described in intention-to-treat analysis and protocol set principle. We will also explore the potential long-term effects and transfer effects. DISCUSSION If a process-based multi-task cognitive training program results in positive changes to executive function in older adults with MCI, this might provide a viable and potential approach to delay the cognitive decline. Clinical Trial Registration: ChiCTR1900020585. Registered on January 09, 2019. http://www.chictr.org.cn/showproj.aspx?proj=34664.
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Affiliation(s)
- Xia Zhao
- School of Medicine, Huzhou University, Huzhou Centre Hospital, Huzhou, China
| | - Lina Wang
- School of Medicine, Huzhou University, Huzhou Centre Hospital, Huzhou, China
| | - Chenxi Ge
- School of Medicine, Huzhou University, Huzhou Centre Hospital, Huzhou, China
| | - Xiaoshen Liu
- School of Medicine, Huzhou University, Huzhou Centre Hospital, Huzhou, China
| | - Mei Chen
- Department of Nursing, Huzhou Rehabilitation Hospital, Huzhou, China
| | - Chen Zhang
- Department of General Medicine, Community Health Service Center of Renhuangshan, Huzhou, China
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Ross LA, Webb CE, Whitaker C, Hicks JM, Schmidt EL, Samimy S, Dennis NA, Visscher KM. The Effects of Useful Field of View Training on Brain Activity and Connectivity. J Gerontol B Psychol Sci Soc Sci 2020; 74:1152-1162. [PMID: 29757433 DOI: 10.1093/geronb/gby041] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 04/11/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Useful Field of View training (UFOVt) is an adaptive computerized cognitive intervention that improves visual attention and transfers to maintained health and everyday functioning in older adults. Although its efficacy is well established, the neural mechanisms underlying this intervention are unknown. This pilot study used functional MRI (fMRI) to explore neural changes following UFOVt. METHOD Task-driven and resting-state fMRI were used to examine changes in brain activity and connectivity in healthy older adults randomized to 10 hr of UFOVt (n = 13), 10 hr of cognitively stimulating activities (CSA; n = 11), or a no-contact control (NC; n = 10). RESULTS UFOVt resulted in reduced task-driven activity in the majority of regions of interest (ROIs) associated with task performance, CSA resulted in reduced activity in one ROI, and there were no changes within the NC group. Relative to NC, UFOVt reduced activity in ROIs involved in effortful information processing. There were no other significant between-group task-based differences. Resting-state functional connectivity between ROIs involved in executive function and visual attention was strengthened following UFOVt compared with CSA and NC. DISCUSSION UFOVt enhances connections needed for visual attention. Together with prior work, this study provides evidence that improvement of the brain's visual attention efficiency is one mechanism underlying UFOVt.
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Affiliation(s)
- Lesley A Ross
- Department of Human Development and Family Studies, University Park
| | - Christina E Webb
- Department of Psychology, The Pennsylvania State University, University Park
| | | | - Jarrod M Hicks
- Department of Neurobiology, The University of Alabama at Birmingham
| | - Erica L Schmidt
- Department of Psychology, The University of Alabama at Birmingham
| | - Shaadee Samimy
- Department of Kinesiology, The Pennsylvania State University, University Park
| | - Nancy A Dennis
- Department of Psychology, The Pennsylvania State University, University Park
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Sprague BN, Phillips CB, Ross LA. Age-Varying Relationships Between Physical Function and Cognition in Older Adulthood. J Gerontol B Psychol Sci Soc Sci 2020; 74:772-784. [PMID: 29121330 DOI: 10.1093/geronb/gbx126] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 09/23/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES There are positive relationships between physical and cognitive function in older adulthood; however, the strength of these relationships are inconsistent across studies. Although novel statistical tools provide flexibility to explore age-related differences in relationship magnitude, such methods have not been implemented in gerontological research. This study applied such methods to examine variations in relationship magnitude between physical function and cognition in healthy older adults (N = 2,783). METHOD Time-varying effects modeling (TVEM) is an extension of regression that models changes in relationships as a function of time-varying metrics like age. TVEM was used to examine if physical function (Turn 360, grip strength) predicted cognitive performance (memory, processing speed/attention, and reasoning) similarly across adults aged 65-90. RESULTS All associations between Turn 360 and all cognitive domains were significant and positive; however, speed of processing had significant magnitude variation across age such that the young-old and the old-old demonstrated the strongest relationships. Associations between grip strength and all cognitive domains significantly strengthened with increased age. DISCUSSION Results suggest that depending on the sample age, there may be inconsistencies in the relationships between physical and cognitive performance. Future research should explore these relationships longitudinally to better elucidate discrepant findings.
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Affiliation(s)
- Briana N Sprague
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | - Christine B Phillips
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | - Lesley A Ross
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
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15
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Chariglione IPFS, Silva HSD, Melo GFD, Vilaça e Silva KHC, Oliveira MLCD. Cognitive interventions and performance measures: a longitudinal study in elderly women. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2020. [DOI: 10.1590/1982-0275202037e190032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Several types of cognitive interventions have been performed with elderly individuals to verify physical and quality of life benefits. The objective of this study was to verify if the cognitive gains found in two cognitive intervention programs are related to changes in the mood, quality of life and physical fitness variables (maximum oxygen consumption, lean mass, fat percentage and handgrip strength). A total of 39 elderly women from the Distrito Federal (Brazil), participating in a cognitive training group based on mnemonic strategies and a group of cognitive stimulation based on perceptual and attention exercises. Both groups showed a tendency to reduce depressive symptoms, an increase in their fat mass and a decrease in their lean mass. Taken together, these findings may contribute to identify the directionality of mnemonic interventions in Brazilian elderly individuals regarding the subjective and physical performance variables.
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Weng W, Liang J, Xue J, Zhu T, Jiang Y, Wang J, Chen S. The Transfer Effects of Cognitive Training on Working Memory Among Chinese Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. Front Aging Neurosci 2019; 11:212. [PMID: 31474850 PMCID: PMC6702334 DOI: 10.3389/fnagi.2019.00212] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/26/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: To explore the transfer effects of cognitive training on working memory among older Chinese adults with mild cognitive impairment (MCI). Methods: Sixty-two MCI participants aged more than 60 years old were recruited by holding recruitment sessions in communities in China [33 for cognitive training, and 29 for mental leisure activities (MLA) control]. Cognitive functions, including working memory, execution function, reasoning ability, verbal ability, ability of daily living, were measured at three time-points (baseline, post-training and 3 months after training). Results: Compared to the MLA control, the cognitive training group showed significant effects in both the trained (working memory) and untrained (execution function and ability of daily living) domains. The effects of cognitive training on overall cognitive function, working memory and daily life ability of daily living of MCI could be maintained for at least 3 months, even without the cognitive training. Besides, complete mediating effects of cognitive training were found in executive function through working memory and working memory in ability of daily living though executive function, which suggests the presence of transfer effect of cognitive training. Conclusions: The present study supported that cognitive training could effectively improve working memory in elders with MCI. The training effects on working memory could transfer to other untrained areas (such as executive function), which also improved the comprehensive ability (ability of daily living). And the effects of training could largely persist for 3 months.
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Affiliation(s)
- Wenqi Weng
- Department of Psychology, Zhejiang University, Zhejiang, China
| | - Jiaming Liang
- Department of Psychology, Zhejiang University, Zhejiang, China
| | - Jiang Xue
- Department of Psychology, Zhejiang University, Zhejiang, China
| | - Tingfei Zhu
- Department of Psychology, Zhejiang University, Zhejiang, China
| | - Yuxing Jiang
- Department of Psychology, Zhejiang University, Zhejiang, China
| | - Jiayu Wang
- Department of Psychology, Zhejiang University, Zhejiang, China
| | - Shulin Chen
- Department of Psychology, Zhejiang University, Zhejiang, China
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Phillips CB, Freed SA, Ross LA. Older Adult Lifespace Varies by Driving Status and Residential Population Density. TRANSPORTATION RESEARCH RECORD 2019; 2673:586-595. [PMID: 32773923 PMCID: PMC7413609 DOI: 10.1177/0361198119846092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Individual- and environmental-level factors may explain differential trajectories in lifespace mobility in older adults. The current study tested whether driving status was associated with lifespace, whether lifespace change varied by driving status, and whether residential context moderated the relationship between driving status and lifespace. Participants were older adults ages 65 to 94 (mean = 73.6 + 5.9) enrolled in the Advanced Cognitive Training for Independent and Vital Elderly Study (N = 2,792). Lifespace and driving status were assessed at baseline and first, second, third, and fifth annual follow-up visits. Residential population density was measured as the population density for participants' enrollment site counties. Two sites were categorized as low density (< 600 per square mile) and four sites were categorized as high density (> 1,200 per square mile). Multilevel longitudinal models tested relationships between driving status, residential population density, and lifespace over five years. After controlling for potential confounders, results indicated that non-drivers had smaller mean lifespace than drivers across five years. Rates of lifespace declines did not differ between drivers and non-drivers. Non-drivers at baseline residing in low population density areas had smaller lifespace than non-drivers in high population density areas and all drivers regardless of population density. The findings suggest that residential context plays a role in older adults' travel behaviors and choices. Further research is needed to understand what residential characteristics support or hinder lifespace maintenance for older adult non-drivers, such as availability and usability of transportation and walkability.
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Affiliation(s)
- Christine B Phillips
- Arizona State University College of Health Solutions Mail Code: 9020 550 N. 3 Street Phoenix, AZ 85004
| | - Sara A Freed
- The Pennsylvania State University 119 Health and Human Development Building University Park, PA 16802
| | - Lesley A Ross
- The Pennsylvania State University 119 Health and Human Development Building University Park, PA 16802
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The impact of behavioral interventions on cognitive function in healthy older adults: A systematic review. Ageing Res Rev 2019; 52:32-52. [PMID: 31002885 DOI: 10.1016/j.arr.2019.04.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 04/06/2019] [Accepted: 04/08/2019] [Indexed: 11/22/2022]
Abstract
Behavioral interventions to improve cognitive function in older adults are widespread and can vary from theater classes to cognitive training programs. However, the effectiveness in maintaining different cognitive domains varies greatly both across and within intervention types. To date, no systematic reviews have synthesized findings across more than a few types of interventions (e.g., cognitive vs. exercise). This systematic review examined 11 types of behavioral interventions and the respective transfer to 19 cognitive domains, as well as transfer to everyday function. Study inclusion criteria were: peer-reviewed articles in English, samples of healthy adults aged 65 and older, and randomized controlled trials of behavioral interventions with reported cognitive outcomes. The 2017 search yielded 75 eligible articles comprising cognitive training, exercise training, combination interventions, cognitively-stimulating activities, and action video games. In general, process- (n = 26) and strategy-based (n = 16) cognitive training improved the trained domains but had weak transfer to non-trained domains. Aerobic training (n = 13) most consistently improved executive function, and strength/resistance (n = 8) and aerobic/resistance combination training (n = 6) most consistently improved cognitive inhibition and visual working memory. Combination interventions (n = 15 nonfactorial, n = 3 factorial) showed promise in improving verbal delayed recall and executive function. Few studies examined cognitively-stimulating activities or action video games, leaving inconclusive results about their effect on cognitive function. Few studies examined everyday function (n = 9), however, process- and strategy-based training demonstrated notable long-term transfer. Recommendations for future research and practice are highlighted.
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