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Kunkler MC, Falkenreck JM, Ophey A, Dencker K, Friese A, Jahr P, Kalbe E, Nelles G, Polidori MC. Long-Term Effects of the Multicomponent Program BrainProtect ® on Cognitive Function: One-Year Follow-Up in Healthy Adults. J Alzheimers Dis Rep 2024; 8:1069-1087. [PMID: 39114551 PMCID: PMC11305852 DOI: 10.3233/adr-230199] [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: 12/23/2023] [Accepted: 06/14/2024] [Indexed: 08/10/2024] Open
Abstract
Background Age-related neuronal changes impact cognitive integrity, which is a major contributor to health and quality of life. The best strategy to prevent cognitive decline and Alzheimer's disease is still debated. Objective To investigate the long-term effects of the eight-week multicomponent training program BrainProtect® on cognitive abilities compared to general health counseling (GHC) in cognitively healthy adults in Germany. Methods Healthy adults (age ≥50 years) previously randomized to either GHC (n = 72) or BrainProtect (intervention group, IG, n = 60) for eight-weeks (once weekly, 90 minutes, group-based) underwent a comprehensive neuropsychological test battery and health-related quality of life (HRQoL) evaluation 3- and 12-months after intervention end. Results Dropout rates were n = 8 after 3 months and n = 19 after 12 months. No significant long-term effect of BrainProtect was observed for the primary endpoint Consortium to Establish a Registry for Alzheimer's Disease (CERAD-Plus) total score. Logical reasoning was significantly improved (p = 0.024) 12 months after completion of the training program in IG participants compared to the GHC group independent of sex, age, education, diet, and physical activity. In IG participants, thinking flexibility (p = 0.019) and confrontational naming (p = 0.010) were improved 3 months after completing the intervention compared to the GHC group, however, after conservative Bonferroni adjustment, significance was lost. Conclusions BrainProtect® independently improved logical reasoning compared to GHC up to 12 months after cognitive training's end in healthy adults. To uncover the long-term clinical significance of multicomponent cognitive training in healthy adults, studies with larger sample size and frequent follow up visits are necessary.
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Affiliation(s)
- Michelle Celine Kunkler
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Maria Falkenreck
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anja Ophey
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Katharina Dencker
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - M. Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Response in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Funghi G, Meli C, Cavagna A, Bisoffi L, Zappini F, Papagno C, Dodich A. The Social and Cognitive Online Training (SCOT) project: A digital randomized controlled trial to promote socio-cognitive well-being in older adults. Arch Gerontol Geriatr 2024; 122:105405. [PMID: 38531149 DOI: 10.1016/j.archger.2024.105405] [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: 11/17/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES Effective prevention programs targeting risk factors for cognitive decline in the elderly are recommended given the progressive increase in the aging of the general population. The Social and Cognitive Online Training (SCOT) project is a randomized, controlled, parallel clinical trial designed to prevent the age-related decline in executive and social functions. METHODS The study included 60 cognitively healthy older adults (age = 71.8±5.3, education = 12.3±3.7, MoCA = 25.1±2.4). Participants underwent a baseline clinical and neuropsychological assessment and were then assigned to either an experimental group (SCOT) or a non-specific cognitive training group (CON). Both 8-week digital interventions included two individual cognitive training sessions and one group meeting per week. Post-intervention assessment evaluated the efficacy of the training on specific outcome measures: the Tower of London for executive functioning, the Ekman-60 Faces test, and the Mini-Social cognition & Emotional Assessment battery for social cognition. A measure of loneliness was included as an exploratory outcome. RESULTS Baseline demographic and neuropsychological characteristics were balanced between SCOT (n = 29) and CON (n = 28) groups. Pre-post-intervention analyses showed improvements in executive functioning and social cognition in both groups, without significant interaction effects. Exploratory post-hoc analyses stratifying the SCOT group by training performance showed significant post-training improvements in executive functioning, emotion recognition, and cognitive theory of mind for high-performing participants. DISCUSSION Results provide preliminary evidence for the beneficial effects of SCOT training, particularly for those who performed best during the training. The SCOT training could represent a new intervention to promote socio-cognitive well-being in the context of active ageing and dementia prevention.
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Affiliation(s)
- Giulia Funghi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Claudia Meli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Arianna Cavagna
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Lisa Bisoffi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Francesca Zappini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy.
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Ophey A, Röttgen S, Pauquet J, Weiß KL, Scharfenberg D, Doppler CEJ, Seger A, Hansen C, Fink GR, Sommerauer M, Kalbe E. Cognitive training and promoting a healthy lifestyle for individuals with isolated REM sleep behavior disorder: study protocol of the delayed-start randomized controlled trial CogTrAiL-RBD. Trials 2024; 25:428. [PMID: 38943191 PMCID: PMC11214208 DOI: 10.1186/s13063-024-08265-9] [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] [Received: 11/13/2023] [Accepted: 06/18/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Isolated REM sleep behavior disorder (iRBD) is an early α-synucleinopathy often accompanied by incipient cognitive impairment. As executive dysfunctions predict earlier phenotypic conversion from iRBD to Parkinson's disease and Lewy body dementia, cognitive training focusing on executive functions could have disease-modifying effects for individuals with iRBD. METHODS The study CogTrAiL-RBD investigates the short- and long-term effectiveness and the feasibility and underlying neural mechanisms of a cognitive training intervention for individuals with iRBD. The intervention consists of a 5-week digital cognitive training accompanied by a module promoting a healthy, active lifestyle. In this monocentric, single-blinded, delayed-start randomized controlled trial, the intervention's effectiveness will be evaluated compared to an initially passive control group that receives the intervention in the second, open-label phase of the study. Eighty individuals with iRBD confirmed by polysomnography will be consecutively recruited from the continuously expanding iRBD cohort at the University Hospital Cologne. The evaluation will focus on cognition and additional neuropsychological and motor variables. Furthermore, the study will examine the feasibility of the intervention, effects on physical activity assessed by accelerometry, and interrogate the intervention's neural effects using magnetic resonance imaging and polysomnography. Besides, a healthy, age-matched control group (HC) will be examined at the first assessment time point, enabling a cross-sectional comparison between individuals with iRBD and HC. DISCUSSION This study will provide insights into whether cognitive training and psychoeducation on a healthy, active lifestyle have short- and long-term (neuro-)protective effects for individuals with iRBD. TRIAL REGISTRATION The study was prospectively registered in the German Clinical Trial Register (DRKS00024898) on 2022-03-11, https://drks.de/search/de/trial/DRKS00024898 . PROTOCOL VERSION V5 2023-04-24.
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Affiliation(s)
- Anja Ophey
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany.
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.
| | - Sinah Röttgen
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Julia Pauquet
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Kim-Lara Weiß
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Daniel Scharfenberg
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Christopher E J Doppler
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Aline Seger
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Clint Hansen
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Gereon R Fink
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Michael Sommerauer
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
- Center of Neurology, Department of Parkinson, Sleep and Movement Disorders, University of Bonn, Bonn, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
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Zając-Lamparska L. Limited training and transfer effects in older and young adults who participated in 12 sessions of process-based working memory training. A three-armed pretest-posttest design study. BMC Res Notes 2024; 17:181. [PMID: 38943197 PMCID: PMC11214245 DOI: 10.1186/s13104-024-06844-2] [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] [Received: 01/22/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE Numerous studies confirm the effectiveness of cognitive training in older adults. However, there is limited evidence of the transfer occurrence. The part of the study presented here tested the effect of 12 process-based working memory training sessions on the performance of the trained task (training effect) and other cognitive tasks (transfer effect). A pretest-posttest study design with one experimental group and two control (passive and active) groups. The sample comprised three groups of older adults: experimental (n = 25), passive control (n = 22), active control (n = 7), and young adults: experimental (n = 25), passive control (n = 25), and active control (n = 12). The study was registered after completion with a ClinicalTrials.gov Identifier: NCT06235840 on 31 January 2024. RESULTS Under the influence of training, the performance of the trained task improved significantly, but only in young adults. Transfer of WM training effects was not revealed. Among young adults, a testing effect was observed for the indicator of attentional focus and psychomotor speed. Moreover, the obtained results suggest the transfer from practice in multi-domain training, implemented in the active control group, to tasks that require the use of fluid intelligence. However, this finding should be interpreted with great caution due to the small size of active control groups.
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Jack S, Andritsch E, Joaquim A, Kreissl M, Locati L, Netea-Maier R, Reverter J, Elisei R. Current landscape and support for practical initiation of oncological prehabilitation translatable to thyroid cancer: A position paper. Heliyon 2024; 10:e30723. [PMID: 38813200 PMCID: PMC11133508 DOI: 10.1016/j.heliyon.2024.e30723] [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: 06/12/2023] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Despite a growing body of evidence for the effectiveness of prehabilitation, the uptake of prehabilitation in Europe remains low. Contributing factors range from limited awareness and understanding of prehabilitation to a lack of supporting infrastructure and reimbursement challenges. In this position paper, the authors propose a new comprehensive definition of prehabilitation and identify differentiated thyroid cancer as a type of cancer particularly well-suited for prehabilitation. To support clinicians with the implementation of prehabilitation programs in their clinics, the authors discuss the following practical solutions: a) find the most appropriate prehabilitation program for each patient; b) raise awareness among peers; c) develop evidence to demonstrate the effectiveness of prehabilitation; d) expand the interdisciplinary team; e) expand your network and make use of existing assets; f) utilize learnings from the COVID-19 pandemic.
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Affiliation(s)
- S. Jack
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - E. Andritsch
- Clinical Department of Oncology, University Medical Centre of Internal Medicine, Medical University of Graz, Auenbruggerpl. 2, 8036, Graz, Austria
| | - A. Joaquim
- ONCOMOVE®, Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), 4410-406, Vila Nova de Gaia, Portugal
| | - M.C. Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Otto von Guericke University, Universitatsplätz 2, 39106, Magdeburg, Germany
| | - L. Locati
- Department of Internal Medicine and Therapeutics, University of Pavia, S. da Nuova, 65, 27100, Pavia, PV, Italy
- Medical Oncology Unit, IRCCS ICS, Maugeri, Via Salvatore Maugeri, 10, 27100 Pavia PV, Italy
| | - R.T. Netea-Maier
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Geert Grooteplein Zuid 28, 6525, GA, Nijmegen, the Netherlands
| | - J.L. Reverter
- Endocrinology and Nutrition Department, Germans Trias i Pujol University Hospital, Universidad Autónoma de Barcelona, Placa Civica, 08193, Bellaterra, Barcelona, Spain
| | - R. Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126, Pisa, PI, Italy
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Verhülsdonk S, Folkerts AK, Hasenberg C, Bohn C, Christl J, Kalbe E, Krieger T. Cognitive training for older prisoners: a qualitative analysis of prisoners' and staff members' perceptions. Front Aging Neurosci 2024; 15:1332136. [PMID: 38259639 PMCID: PMC10800784 DOI: 10.3389/fnagi.2023.1332136] [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: 11/02/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Correctional institutions are challenged by increasing numbers of older prisoners. Existing literature highlights the vulnerability of this group that is reflected by various somatic and mental health issues including cognitive dysfunctions. Although cognitive training studies in various target groups of older people have been conducted, there is lack of data regarding cognitive training in older prisoners. A structured cognitive group training program ("NEUROvitalis Prison") with 12 weekly sessions was offered to male prisoners in Germany. Methods Post intervention an exploratory qualitative study was conducted. Prisoners (N = 18) and staff (N = 4) perspectives were explored by conducting face-to-face semi-structured interviews. Audiotaped data were fully transcribed and deductive-inductive content analyses applied. Results Both the prisoners and the staff perceived the cognitive training as very positive and stimulating. Moreover, the importance of the training was pronounced in terms of an increase in self-esteem and understanding of cognition and aging in the prisoners. Discussion Our data indicate that cognitive training may be a feasible and valuable intervention for older prisoners that will be appreciated by both inmates and staff. The qualitative data provide substantial insight into the experiences with the applied cognitive training program. Moreover, valuable modifications for future conduct can be derived.
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Affiliation(s)
- Sandra Verhülsdonk
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Caroline Hasenberg
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Claire Bohn
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Julia Christl
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Theresia Krieger
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Li Z, He H, Chen Y, Guan Q. Effects of engagement, persistence and adherence on cognitive training outcomes in older adults with and without cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Age Ageing 2024; 53:afad247. [PMID: 38266127 DOI: 10.1093/ageing/afad247] [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] [Received: 07/13/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Limited understanding exists regarding the influences of engagement, persistence and adherence on the efficacy of cognitive training for age-related cognitive decline and neurodegenerative cognitive impairment. METHODS This study conducted a meta-analysis of randomised controlled trials (RCTs). We systematically searched MEDLINE, PubMed, Web of Science, Embase and CINAHL databases from 1 January 2012 to 13 June 2023, and included RCTs assessing the effects of cognitive training in older adults, both with and without cognitive impairment. Hedges' g with a 95% confidence interval (CI) was used to synthesise cognitive training effect sizes on various neuropsychological tests. Subgroup analyses were conducted based on variables including engagement, persistence, adherence and cognitive conditions of normal cognition, mild cognitive impairment (MCI) or neurodegenerative dementia. RESULTS This meta-analysis included 55 RCTs with 4,455 participants with cognitive conditions spanning normal cognition, MCI and neurodegenerative dementia. The mean age of participants was 73.9 (range: 65.7-84.5) years. Overall, cognitive training showed a significant cross-domain effect (Hedges' g = 0.286, 95% CI: 0.224-0.348). Training effects are significant when engagement or persistence rates exceed 60% or when adherence rates exceed 80%. Higher levels of persistence are required to achieve significant training effects in memory, visuospatial ability and reasoning than in executive function and attention and language. Higher persistence is also required for older adults with normal cognition to achieve significant training gains compared to those with cognitive impairment. CONCLUSIONS This systematic review highlights the critical roles of engagement, persistence and adherence in augmenting the efficacy of cognitive training.
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Affiliation(s)
- Zhen Li
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Hao He
- School of Psychology, Shenzhen University, Shenzhen 518060, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518055, China
| | - Yiqi Chen
- School of Psychology, Shenzhen University, Shenzhen 518060, China
- Department of Psychology, University of Mannheim, Mannheim 68131, Germany
| | - Qing Guan
- School of Psychology, Shenzhen University, Shenzhen 518060, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518055, China
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Olegário RL, Fernandes SR, de Moraes R. Efficacy of cognitive training on executive functions in healthy older adults: a systematic review with meta-analysis of randomized controlled trials. Psychol Health 2023:1-28. [PMID: 37822255 DOI: 10.1080/08870446.2023.2267610] [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: 01/03/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Systematically review randomized controlled trials on the efficacy of cognitive training on executive functions in healthy older people. MEASURES The outcome measures were related to inhibitory control, working memory, and cognitive flexibility. RESULTS Thirty-one trials were included in the systematic review and thirteen trials in the meta-analysis. In the overall analysis, the cognitive training enhanced inhibitory control when measured by the Stroop task (p < .001, d = 1.64) and working memory when measured by the Corsi Block task (p = .002, d = .16). A marginal significance was found for working memory in the Digit Span task - Forward (p = .06, d = .92). However, cognitive training did not enhance inhibitory control when measured by the Go/No-Go task (p = .76, d = .59), working memory when measured by the Digit Span - Backward (p = .72, d = .95) and N-Back (p = .10, d = .26) tasks, and cognitive flexibility when measured by Trail Making - Part B (p = .08, d = .27) and Semantic Fluency (p = .49, d = .06) tasks. CONCLUSION Mixed evidence was found for inhibitory control and working memory; cognitive flexibility showed no evidence of improvement.
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Affiliation(s)
- Raphael Lopes Olegário
- Institute of Psychology, University of Brasília, Brasília, DF, Brazil
- Postgraduate Program in Behavioural Sciences, University of Brasília, Brasília, DF, Brazil
| | | | - Rui de Moraes
- Institute of Psychology, University of Brasília, Brasília, DF, Brazil
- Postgraduate Program in Behavioural Sciences, University of Brasília, Brasília, DF, Brazil
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Wang Y, Gao T, Wang B. Application of mesenchymal stem cells for anti-senescence and clinical challenges. Stem Cell Res Ther 2023; 14:260. [PMID: 37726805 PMCID: PMC10510299 DOI: 10.1186/s13287-023-03497-z] [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: 07/25/2023] [Accepted: 09/13/2023] [Indexed: 09/21/2023] Open
Abstract
Senescence is a hot topic nowadays, which shows the accumulation of senescent cells and inflammatory factors, leading to the occurrence of various senescence-related diseases. Although some methods have been identified to partly delay senescence, such as strengthening exercise, restricting diet, and some drugs, these only slow down the process of senescence and cannot fundamentally delay or even reverse senescence. Stem cell-based therapy is expected to be a potential effective way to alleviate or cure senescence-related disorders in the coming future. Mesenchymal stromal cells (MSCs) are the most widely used cell type in treating various diseases due to their potentials of self-replication and multidirectional differentiation, paracrine action, and immunoregulatory effects. Some biological characteristics of MSCs can be well targeted at the pathological features of aging. Therefore, MSC-based therapy is also a promising strategy to combat senescence-related diseases. Here we review the recent progresses of MSC-based therapies in the research of age-related diseases and the challenges in clinical application, proving further insight and reference for broad application prospects of MSCs in effectively combating senesce in the future.
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Affiliation(s)
- Yaping Wang
- Clinical Stem Cell Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, 210008, People's Republic of China
- Clinical Stem Cell Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China
| | - Tianyun Gao
- Clinical Stem Cell Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, 210008, People's Republic of China
| | - Bin Wang
- Clinical Stem Cell Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, 210008, People's Republic of China.
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Buele J, Palacios-Navarro G. Cognitive-motor interventions based on virtual reality and instrumental activities of daily living (iADL): an overview. Front Aging Neurosci 2023; 15:1191729. [PMID: 37396651 PMCID: PMC10311491 DOI: 10.3389/fnagi.2023.1191729] [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: 03/22/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Non-invasive, non-pharmacological interventions utilizing virtual reality (VR) represent a promising approach to enhancing cognitive function in patients with degenerative cognitive disorders. Traditional "pen and paper" therapies often lack the practical engagement in everyday activities that older individuals encounter in their environment. These activities pose both cognitive and motor challenges, underscoring the necessity of understanding the outcomes of such combined interventions. This review aimed to assess the advantages of VR applications that integrate cognitive-motor tasks, simulating instrumental activities of daily living (iADLs). We systematically searched five databases-Scopus, Web of Science, Springer Link, IEEE Xplore, and PubMed, from their inception until January 31, 2023. Our review revealed that motor movements, coupled with VR-based cognitive-motor interventions, activate specific brain areas and foster improvements in general cognition, executive function, attention, and memory. VR applications that meld cognitive-motor tasks and simulate iADLs can offer significant benefits to older adults. Enhanced cognitive and motor performance can promote increased independence in daily activities, thereby contributing to improved quality of life.
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Affiliation(s)
- Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción, Universidad Indoamérica, Ambato, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, Teruel, Spain
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Düzel E, Thyrian JR. [Mobile everyday-life digital technologies for the prevention of Alzheimer's dementia: cognitive health and cognitive safety]. DER NERVENARZT 2023; 94:400-407. [PMID: 37115257 PMCID: PMC10160180 DOI: 10.1007/s00115-023-01478-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 04/29/2023]
Abstract
It is generally accepted that the treatment of Alzheimer's disease should be flanked by preventive measures for risk reduction in order to maintain cognitive functions for as long as possible; however, the research and development of treatment concepts are both faced with challenges. The preventive risk reduction necessitates a high level of coordination of neurology and psychiatry with other disciplines. Also, patients must develop a high level of health competence and summon up self-motivation and adherence. This concept article deals with the question of how mobile everyday-life digital technologies can help to address these challenges. The core prerequisite is the interdisciplinary coordinated structuring of prevention with the focus on cognitive health and cognitive safety. Cognitive health relates to a reduction of risk factors associated with lifestyle. Cognitive safety concerns the avoidance of iatrogenic side effects on cognitive functions. Digital technologies that are relevant in this context are mobile apps based on smartphones or tablets for everyday-life and high-frequency recording of cognitive functions, apps that can coach the implementation of lifestyle changes as companion technologies, apps that can assist in the reduction of iatrogenic risks and those that can improve the health competence of patients and relatives. The state of development of such medical products is at different stages of progress. Therefore, this concept article does not provide a review of existing products but rather deals with the fundamental interplay of potential solutions in the prevention of Alzheimer dementia in the areas of cognitive health and cognitive safety.
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Affiliation(s)
- Emrah Düzel
- Institut für Kognitive Neurologie und Demenzforschung, Medizinische Fakultät, Universität Magdeburg, Leipziger Str 44, 39120, Magdeburg, Deutschland.
| | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Greifswald, Greifswald, Deutschland
- Lebenswissenschaftliche Fakultät (LWF), Universität Siegen, Siegen, Deutschland
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12
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Michaels J, Chaumillon R, Mejia-Romero S, Bernardin D, Faubert J. Can Three-Dimensional Multiple Object Tracking Training Be Used to Improve Simulated Driving Performance? A Pilot Study in Young and Older Adults. JOURNAL OF COGNITIVE ENHANCEMENT 2023; 7:112-127. [PMID: 37351199 PMCID: PMC10123568 DOI: 10.1007/s41465-023-00260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/27/2023] [Indexed: 06/24/2023]
Abstract
Driving ability has been shown to be dependent on perceptual-cognitive abilities such as visual attention and speed of processing. There is mixed evidence suggesting that training these abilities may improve aspects of driving performance. This preliminary study investigated the feasibility of training three-dimensional multiple object tracking (3D-MOT)-a dynamic, speeded tracking task soliciting selective, sustained and divided attention as well as speed of processing-to improve measures of simulated driving performance in older and younger adults. A sample of 20 young adults (23-33 years old) and 14 older adults (65-76 years old) were randomly assigned to either a 3D-MOT training group or an active control group trained on a perceptual discrimination task as well as 2048. Participants were tested on a driving scenario with skill-testing events previously identified as optimal for cross-sectional comparisons of driving ability. Results replicated previously identified differences in driving behaviour between age groups. A possible trend was observed for the 3D-MOT trained group, especially younger adults, to increase the distance at which they applied their maximum amount of braking in response to dangerous events. This measure was associated with less extreme braking during events, implying that these drivers may have been making more controlled stops. Limitations of sample size and task realism notwithstanding, the present experiment offers preliminary evidence that 3D-MOT training might transfer to driving performance through quicker detection of or reaction to dangerous events and provides a rationale for replication with a larger sample size.
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Affiliation(s)
- Jesse Michaels
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Romain Chaumillon
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Sergio Mejia-Romero
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Delphine Bernardin
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
- Essilor International, Research and Development Department, Paris, France
- Essilor Canada, Saint-Laurent, Canada
| | - Jocelyn Faubert
- Faubert Laboratory, School of Optometry, Université de Montréal, Montréal, Québec Canada
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Rute-Pérez S, Rodríguez-Domínguez C, Vélez-Coto M, Pérez-García M, Caracuel A. Effectiveness of Computerized Cognitive Training by VIRTRAEL on Memory and Executive Function in Older People: A Pilot Study. Brain Sci 2023; 13:brainsci13040684. [PMID: 37190649 DOI: 10.3390/brainsci13040684] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/15/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
The prevalence of people over 60 years of age with cognitive impairment has increased in recent decades. As a consequence, numerous computerized cognitive trainings (CCT) have been developed. This pilot study aimed to determine the effectiveness of the CCT with VIRTRAEL in improving older adults' cognition. Fifty-five participants (x¯ = 72.7 years; SD = 6.5) underwent CCT, and twenty participants (x¯ = 76.1 years; SD = 7.6) received face-to-face cognitive stimulation with a paper-and-pencil methodology. Both trainings were conducted in nine sessions (45-60 min each). Participants completed a pre-post training neuropsychological assessment. ANCOVAs and the standardized clinical change were performed. VIRTRAEL's group showed a significant and greater improvement in verbal learning (p < 0.006) and delayed recall (p ≤ 0.001), working memory (p < 0.005), abstract (p < 0.002) and semantic reasoning (p < 0.015), and planning (p < 0.021). Additionally, more large clinical changes (d > 0.8) were found in the VIRTRAEL condition (in verbal learning and delayed free and cued recall) than in the standard group. Here we show that the CCT with VIRTRAEL is effective in improving cognitive function in older adults and is superior to the standard format. These preliminary findings indicate that CCT is a useful tool potentially applicable in the fight against cognitive symptomatology associated with aging and neurodegenerative diseases. VIRTRAEL represents a breakthrough in this field as it is inexpensive and easily accessible to any older person, regardless of whether they live far from health care resources.
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Affiliation(s)
- Sandra Rute-Pérez
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18011 Granada, Spain
- Department of Developmental and Educational Psychology, Faculty of Education Sciences, University of Granada, 18011 Granada, Spain
| | - Carlos Rodríguez-Domínguez
- Department of Computer Languages and Systems, Faculty of Education, Economy and Technology of Ceuta, University of Granada, 51001 Granada, Spain
| | - María Vélez-Coto
- Department of Psychology, Catholic University of Murcia, Guadalupe, 30107 Murcia, Spain
| | - Miguel Pérez-García
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18011 Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, 18011 Granada, Spain
| | - Alfonso Caracuel
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18011 Granada, Spain
- Department of Developmental and Educational Psychology, Faculty of Education Sciences, University of Granada, 18011 Granada, Spain
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14
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Koo GK, Gaur A, Tumati S, Kusumo RW, Bawa KK, Herrmann N, Gallagher D, Lanctôt KL. Identifying factors influencing cognitive outcomes after anodal transcranial direct current stimulation in older adults with and without cognitive impairment: A systematic review. Neurosci Biobehav Rev 2023; 146:105047. [PMID: 36646259 DOI: 10.1016/j.neubiorev.2023.105047] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Anodal transcranial direct current stimulation (tDCS) can improve cognition in healthy older adults, those with Alzheimer's disease (AD) and mild cognitive impairment (MCI), albeit with considerable variability in response. This systematic review identifies interindividual factors that may influence tDCS outcomes in older individuals with or without cognitive impairment. Peer-reviewed articles were included if they assessed whether cognitive outcomes (memory or global cognition) after tDCS were associated with pre-intervention factors in healthy older adults or individuals with AD/MCI. We identified eight factors that may affect cognitive outcomes after tDCS. Improved tDCS outcomes were predicted by lower baseline cognitive function when tDCS was combined with a co-intervention (but not when used alone). Preserved brain structure and better baseline functional connectivity, genetic polymorphisms, and the use of concomitant medications may predict better tDCS outcomes, but further research is warranted. tDCS outcomes were not consistently associated with age, cognitive reserve, sex, and AD risk factors. Accounting for individual differences in baseline cognition, particularly for combined interventions, may thus maximize the therapeutic potential of tDCS.
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Affiliation(s)
- Grace Ky Koo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Amish Gaur
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Shankar Tumati
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Raphael W Kusumo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Kritleen K Bawa
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada.
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15
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Vanbilsen N, Pergher V, Van Hulle MM. Effects of task-specific strategy on attentional control game training: preliminary data from healthy adults. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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16
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Meltzer JA, Kates Rose M, Le AY, Spencer KA, Goldstein L, Gubanova A, Lai AC, Yossofzai M, Armstrong SEM, Bialystok E. Improvement in executive function for older adults through smartphone apps: a randomized clinical trial comparing language learning and brain training. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:150-171. [PMID: 34694201 DOI: 10.1080/13825585.2021.1991262] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Bilingualism has been linked to improved executive function and delayed onset of dementia, but it is unknown whether similar benefits can be obtained later in life through deliberate intervention. Given the logistical hurdles of second language acquisition in a randomized trial for older adults, few interventional studies have been done thus far. However, recently developed smartphone apps offer a convenient means to acquire skills in a second language and can be compared with brain training apps specifically designed to improve executive function. In a randomized clinical trial, 76 adults aged 65-75 were assigned to either 16 weeks of Spanish learning using the app Duolingo 30 minutes a day, an equivalent amount of brain training using the app BrainHQ, or a waitlist control condition. Executive function was assessed before and after the intervention with preregistered (NCT03638882) tests previously linked to better performance in bilinguals. For two of the primary measures: incongruent Stroop color naming and 2-back accuracy, Duolingo provided equivalent benefits as BrainHQ compared to a control group. On reaction time for N-back and Simon tests, the BrainHQ group alone experienced strong gains over the other two groups. Duolingo was rated as more enjoyable. These results suggest that app-based language learning may provide some similar benefits as brain training in improving executive function in seniors but has less impact on processing speed. However, future advancements in app design may optimize not only the acquisition of the target language but also the side benefits of the language learning experience.
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Affiliation(s)
- Jed A Meltzer
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada.,Department of Psychology, University of Toronto, Toronto ON, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa ON, Canada
| | - Mira Kates Rose
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Anna Y Le
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Kiah A Spencer
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Leora Goldstein
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Alina Gubanova
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Abbie C Lai
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Maryam Yossofzai
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | | | - Ellen Bialystok
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada.,Department of Psychology, York University, Toronto ON, Canada
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17
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Falkenreck JM, Kunkler MC, Ophey A, Weigert H, Friese A, Jahr P, Nelles G, Kalbe E, Polidori MC. Effects of the Multicomponent Cognitive Training Program BrainProtect in Cognitively Healthy Adults: A Randomized Controlled Trial. J Alzheimers Dis 2023; 94:1013-1034. [PMID: 37393493 DOI: 10.3233/jad-220619] [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: 07/03/2023]
Abstract
BACKGROUND Cognitive integrity is a fundamental driver of health. The exact structure of strategies against cognitive impairment is still under debate. OBJECTIVE To compare the short-term effects of a multicomponent cognitive training (BrainProtect) with those of general health counseling (GHC) on cognitive abilities and health-related quality of life (HRQoL) in healthy adults in Germany. METHODS In this parallel randomized controlled trial (RCT), 132 eligible cognitively healthy adults (age ≥50 years, Beck Depression Inventory ≤9/63; Montreal Cognitive Assessment ≥26/30) were randomized to either GHC (N = 72) or to intervention with BrainProtect (intervention group, IG; N = 60). IG participants received 8 weekly sessions of 90 min of the group-based BrainProtect program focusing on executive functions, concentration, learning, perception, and imagination, plus nutritional and physical exercise units. Before and after intervention, all participants underwent neuropsychological testing and HRQoL evaluation, blinded for pretest. RESULTS No significant training effect was observed for the primary endpoint of global cognition as assessed by CERAD-Plus-z Total Score (p = 0.113; ηp2 = 0.023). Improvements in several cognitive subtests were shown in the IG (N = 53) compared to the GHC (N = 62) without adverse events. Differences reached significance for verbal fluency (p = 0.021), visual memory (p = 0.013), visuo-constructive functions (p = 0.034), and HRQoL (p = 0.009). Significance was lost after adjustment, though several changes were clinically relevant. CONCLUSION BrainProtect did not significantly impact global cognition in this RCT. Nevertheless, the results of some outcomes indicate clinically meaningful changes, so that a strengthening of the cognitive performance by BrainProtect cannot be excluded. Further studies with larger sample size are needed to confirm these findings.
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Affiliation(s)
- Julia Maria Falkenreck
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michelle Celine Kunkler
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anja Ophey
- Department of Medical Psychology ∣ Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Hannah Weigert
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | | | | | - Elke Kalbe
- Department of Medical Psychology ∣ Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - M Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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18
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Kumagai R, Osaki T, Oki Y, Murata S, Uchida K, Encho H, Ono R, Kowa H. The Japan-Multimodal Intervention Trial for Prevention of Dementia PRIME Tamba (J-MINT PRIME Tamba): Study protocol of a randomised controlled multi-domain intervention trial. Arch Gerontol Geriatr 2023; 104:104803. [PMID: 36088747 DOI: 10.1016/j.archger.2022.104803] [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: 06/06/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 02/07/2023]
Abstract
The Japan-Multimodal Intervention Trial for Prevention of Dementia PRIME Tamba (J-MINT PRIME Tamba) is a randomised controlled trial to prevent cognitive decline in community-dwelling cognitively ordinary older people at risk of dementia. Participants are aged 65-85 years living in a rural area in Japan, aware of very mild decline in cognitive function or abilities of activities of daily living, have at least one vascular risk (e.g. hypertension or diabetes), and have a Mini-Mental State Examination score of 24 or higher. Approximately 200 participants are randomly divided into two groups, with the intervention group receiving a multi-modal intervention, including lifestyle-related disease management, physical exercise, cognitive training, and nutritional counselling, over 18 months. The primary outcome is change in the composite score of seven neuropsychological tests, including the Free and Cued Selective Reminding Test, Logical Memory I and II subsets of the Wechsler Memory Scale-Revised, and Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale. In addition, changes in a wide range of other parameters such as physical function, blood test results, sleep, and frailty are also analysed as secondary outcomes. We believe that this study's results will contribute significantly to the development of dementia prevention measures in Japan. Clinical trial registration number: UMIN000041938.
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Affiliation(s)
- Ryoko Kumagai
- Division of Cognitive and Psychiatric Rehabilitation, Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
| | - Tohmi Osaki
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe, Hyogo 651-2180, Japan.
| | - Yutaro Oki
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
| | - Shunsuke Murata
- Centre for Preventing Dementia, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibeshimmachi, Suita, Osaka 564-8565, Japan
| | - Kazuaki Uchida
- Division of Community Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Haruhi Encho
- Division of Community Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
| | - Rei Ono
- Division of Community Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan; Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1, Toyama, Shinjyuku, Tokyo 162-8636, Japan
| | - Hisatomo Kowa
- Division of Cognitive and Psychiatric Rehabilitation, Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan.
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Ro D, Lee J, Lee G, Shin S, Kim YH. Effect of interactive multitouch game-based cognitive intervention on cognitive function in older adults: A randomized controlled trial. Digit Health 2023; 9:20552076231176648. [PMID: 37256004 PMCID: PMC10226180 DOI: 10.1177/20552076231176648] [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: 08/24/2022] [Accepted: 05/02/2023] [Indexed: 06/01/2023] Open
Abstract
Purpose This study investigated the effects of an interactive multitouch game-based cognitive intervention (ICI) on cognitive function in community-dwelling older adults. Methods Thirty-two older adults (19 women) between 65 and 84 years of age (mean age, 74.47 ± 4.30 years) without a history of neurological disease participated. They were randomized into two groups: intervention and control. The intervention group took part in ICI sessions using HAPPYTABLE® (Spring Soft Co. Ltd, Seoul, Korea) (ICI group), and the control group underwent a traditional paper-and-pencil-based cognitive intervention (TCI group). Both groups completed 10 intervention sessions over four consecutive weeks. Cognitive function was assessed before (pre-intervention) and after (post-intervention) intervention. Executive function was evaluated through the Color-Word Stroop Test (CWST) and Controlled Oral Word Association Test (COWAT). Memory was assessed through the Verbal Learning Test (VLT) and Rey Complex Figure Test (RCFT). Results The ICI and TCI groups showed significant improvements in some cognitive functions after the intervention. Both groups showed substantial improvements in VLT and RCFT (P < 0.05), reflecting memory function. Regarding the executive role, the ICI group showed significant post-intervention improvements in the conditions of the CWST incongruent (ICI 76.31 ± 23.82; P = 0.004) compared to the pre-intervention scores. ANCOVA with pre-intervention scores and gender as covariates revealed improved results in the ICI group compared with the VLT delayed (ICI 9.18 ± 1.68, TCI 7.56 ± 2.13; P = 0.015) and VLT recognition task (ICI 22.81 ± 1.22, TCI 21.38 ± 1.09; P = 0.035). Conclusions These findings revealed that both ICI and TCI helped increase cognitive performance in community-dwelling older persons; nevertheless, ICI showed better improvement in memory function than TCI. Thus, the ICI can be used to improve cognitive performance among older adults living in the community.
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Affiliation(s)
- Daeun Ro
- Department of Medical Device Management
& Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Physical and
Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jungsoo Lee
- Department of Medical IT Convergence
Engineering, Kumoh National Institute of
Technology, Gumi, Republic of Korea
| | - Gihyoun Lee
- Department of Physical and
Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and
Technology, SAIHST, Seoul, Republic of Korea
| | - Seyoung Shin
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of
Korea
| | - Yun-Hee Kim
- Department of Medical Device Management
& Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Physical and
Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and
Technology, SAIHST, Seoul, Republic of Korea
- Department of Rehabilitation, Haeundae
Sharing and Happiness Hospital, Pusan, Republic of Korea
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20
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Butz M, Meyer R, Gerriets T, Sammer G, Doerr JM, El-Shazly J, Doeppner TR, Choi YH, Schoenburg M, Juenemann M. Increasing preoperative cognitive reserve to prevent postoperative delirium and postoperative cognitive decline in cardiac surgical patients (INCORE): Study protocol for a randomized clinical trial on cognitive training. Front Neurol 2022; 13:1040733. [PMID: 36578306 PMCID: PMC9791586 DOI: 10.3389/fneur.2022.1040733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Postoperative delirium (POD) and postoperative cognitive decline (POCD) can be observed after cardiosurgical interventions. Taken together, these postoperative neurocognitive disorders (PNCDs) contribute to increased morbidity and mortality. Preoperative risk factors of PNCD, such as decreased neuropsychometric performance or decreased cognitive daily activities, can be interpreted as reduced cognitive reserve. This study aims to build up cognitive reserves to protect against the development of PNCD through preoperative, home-based, cognitive training. Methods The planned research project is a monocentric, two-arm randomized controlled intervention study involving 100 patients undergoing elective cardiac surgery with extracorporeal circulation. Patients will be assigned to a training group or control group. The intervention involves a standardized, paper-and-pencil-based cognitive training that will be performed by the patients at home for ~40 min per day over a preoperative period of 2-3 weeks. The control group will receive neither cognitive training nor a placebo intervention. A detailed assessment of psychological functions will be performed ~2-3 weeks before the start of training, at the end of the training, during hospitalization, at discharge from the acute clinic, and 3 months after surgery. The primary objective of this study is to investigate the interventional effect of preoperative cognitive training on the incidence of POD during the stay in the acute clinic, the incidence of POCD at the time of discharge from the acute clinic, and 3 months after surgery. Secondary objectives are to determine the training effect on objective cognitive functions before the surgery and subjective cognitive functions, as well as health-related quality of life 3 months after surgery. Discussion Should it become evident that the use of our cognitive training can both reduce the incidence of POCD and POD and improve health-related quality of life, this intervention may be integrated into a standardized prehabilitation program.
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Affiliation(s)
- Marius Butz
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany,Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany,*Correspondence: Marius Butz
| | - Rolf Meyer
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Tibo Gerriets
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany,Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany
| | - Gebhard Sammer
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany,Cognitive Neuroscience at the Centre of Psychiatry, University Giessen, Giessen, Germany,Department of Psychology, Justus-Liebig University, Giessen, Germany
| | - Johanna M. Doerr
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany,Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany
| | - Jasmin El-Shazly
- Department of Psychocardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Thorsten R. Doeppner
- Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany
| | - Yeong-Hoon Choi
- Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Markus Schoenburg
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany,Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - Martin Juenemann
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany,Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany
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21
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Singh A, Chakraborty S, He Z, Tian S, Zhang S, Lustria MLA, Charness N, Roque NA, Harrell ER, Boot WR. Deep learning-based predictions of older adults' adherence to cognitive training to support training efficacy. Front Psychol 2022; 13:980778. [PMID: 36467206 PMCID: PMC9713845 DOI: 10.3389/fpsyg.2022.980778] [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: 06/28/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
As the population ages, the number of older adults experiencing mild cognitive impairment (MCI), Alzheimer's disease, and other forms of dementia will increase dramatically over the next few decades. Unfortunately, cognitive changes associated with these conditions threaten independence and quality of life. To address this, researchers have developed promising cognitive training interventions to help prevent or reverse cognitive decline and cognitive impairment. However, the promise of these interventions will not be realized unless older adults regularly engage with them over the long term, and like many health behaviors, adherence to cognitive training interventions can often be poor. To maximize training benefits, it would be useful to be able to predict when adherence lapses for each individual, so that support systems can be personalized to bolster adherence and intervention engagement at optimal time points. The current research uses data from a technology-based cognitive intervention study to recognize patterns in participants' adherence levels and predict their future adherence to the training program. We leveraged the feature learning capabilities of deep neural networks to predict patterns of adherence for a given participant, based on their past behavior. A separate, personalized model was trained for each participant to capture individualistic features of adherence. We posed the adherence prediction as a binary classification problem and exploited multivariate time series analysis using an adaptive window size for model training. Further, data augmentation techniques were used to overcome the challenge of limited training data and enhance the size of the dataset. To the best of our knowledge, this is the first research effort to use advanced machine learning techniques to predict older adults' daily adherence to cognitive training programs. Experimental evaluations corroborated the promise and potential of deep learning models for adherence prediction, which furnished highest mean F-scores of 75.5, 75.5, and 74.6% for the Convolution Neural Network (CNN), Long Short-Term Memory (LSTM) network, and CNN-LSTM models respectively.
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Affiliation(s)
- Ankita Singh
- Department of Computer Science, Florida State University, Tallahassee, FL, United States
| | - Shayok Chakraborty
- Department of Computer Science, Florida State University, Tallahassee, FL, United States,*Correspondence: Shayok Chakraborty
| | - Zhe He
- School of Information, Florida State University, Tallahassee, FL, United States,College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Shubo Tian
- Department of Statistics, Florida State University, Tallahassee, FL, United States
| | - Shenghao Zhang
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Mia Liza A. Lustria
- School of Information, Florida State University, Tallahassee, FL, United States
| | - Neil Charness
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Nelson A. Roque
- Department of Psychology, University of Central Florida, Orlando, FL, United States
| | - Erin R. Harrell
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, United States
| | - Walter R. Boot
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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22
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Essery R, Pollet S, Bradbury K, Western MJ, Grey E, Denison-Day J, Smith KA, Hayter V, Kelly J, Somerville J, Stuart B, Becque T, Zhang J, Slodkowska-Barabasz J, Mowbray F, Ferrey A, Yao G, Zhu S, Kendrick T, Griffin S, Mutrie N, Robinson S, Brooker H, Griffiths G, Robinson L, Rossor M, Ballard C, Gallacher J, Rathod S, Gudgin B, Phillips R, Stokes T, Niven J, Little P, Yardley L. Parallel randomized controlled feasibility trials of the "Active Brains" digital intervention to protect cognitive health in adults aged 60-85. Front Public Health 2022; 10:962873. [PMID: 36203694 PMCID: PMC9530972 DOI: 10.3389/fpubh.2022.962873] [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: 06/06/2022] [Accepted: 08/30/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Multidomain interventions to address modifiable risk factors for dementia are promising, but require more cost-effective, scalable delivery. This study investigated the feasibility of the "Active Brains" digital behavior change intervention and its trial procedures. Materials and methods Active Brains aims to reduce cognitive decline by promoting physical activity, healthy eating, and online cognitive training. We conducted 12-month parallel-design randomized controlled feasibility trials of "Active Brains" amongst "lower cognitive scoring" (n = 180) and "higher cognitive scoring" (n = 180) adults aged 60-85. Results We collected 67.2 and 76.1% of our 12-month primary outcome (Baddeley verbal reasoning task) data for the "lower cognitive score" and "higher cognitive score" groups, respectively. Usage of "Active Brains" indicated overall feasibility and satisfactory engagement with the physical activity intervention content (which did not require sustained online engagement), but engagement with online cognitive training was limited. Uptake of the additional brief telephone support appeared to be higher in the "lower cognitive score" trial. Preliminary descriptive trends in the primary outcome data might indicate a protective effect of Active Brains against cognitive decline, but further investigation in fully-powered trials is required to answer this definitively. Discussion Whilst initial uptake and engagement with the online intervention was modest, it was in line with typical usage of other digital behavior change interventions, and early indications from the descriptive analysis of the primary outcome and behavioral data suggest that further exploration of the potential protective benefits of Active Brains are warranted. The study also identified minor modifications to procedures, particularly to improve online primary-outcome completion. Further investigation of Active Brains will now seek to determine its efficacy in protecting cognitive performance amongst adults aged 60-85 with varied levels of existing cognitive performance.
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Affiliation(s)
- Rosie Essery
- University of Southampton, Southampton, United Kingdom,*Correspondence: Rosie Essery
| | | | - Katherine Bradbury
- University of Southampton, Southampton, United Kingdom,NIHR ARC Wessex, Southampton, United Kingdom
| | | | | | | | | | | | - Joanne Kelly
- University of Southampton, Southampton, United Kingdom
| | | | - Beth Stuart
- University of Southampton, Southampton, United Kingdom,Queen Mary University of London, London, United Kingdom
| | - Taeko Becque
- University of Southampton, Southampton, United Kingdom
| | - Jin Zhang
- University of Southampton, Southampton, United Kingdom
| | | | | | - Anne Ferrey
- University of Oxford, Oxford, United Kingdom
| | - Guiqing Yao
- University of Leicester, Leicester, United Kingdom
| | - Shihua Zhu
- University of Southampton, Southampton, United Kingdom
| | - Tony Kendrick
- University of Southampton, Southampton, United Kingdom
| | | | | | | | | | - Gareth Griffiths
- NIHR Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | | | | | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Southampton, United Kingdom
| | - Bernard Gudgin
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Rosemary Phillips
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Tom Stokes
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - John Niven
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Paul Little
- University of Southampton, Southampton, United Kingdom
| | - Lucy Yardley
- University of Southampton, Southampton, United Kingdom,University of Bristol, Bristol, United Kingdom
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23
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Abstract
PURPOSE OF REVIEW We review recent work on applications of non-pharmacologic strategies to promote cognitive health in older adulthood and discuss potential network mechanisms, limitations, and considerations for improving intervention uptake and efficacy. RECENT FINDINGS In healthy older adults and patients with mild cognitive impairment, cognitive training produces global and domain-specific cognitive gains, though effect sizes tend to be modest and transfer is variable. Non-invasive brain stimulation has shown moderate success in enhancing cognitive function, though the optimum approach, parameters, and cortical targets require further investigation. Physical activity improves cognitive functions in late life, with emerging trials highlighting key intervention components that may maximize treatment outcomes. Multimodal interventions may be superior to single-component interventions in conferring cognitive gains, although interpretation is limited by modest sample sizes and variability in training components and parameters. Across modalities, individual differences in patient characteristics predict therapeutic response. These interventions may advance cognitive health by modulating functional networks that support core cognitive abilities including the default mode, executive control, and salience networks. Effectiveness of cognitive enhancement strategies may be increased with clinician-led coaching, booster sessions, gamification, integration of multiple intervention modalities, and concrete applications to everyday functioning. Future trials involving rigorous comparisons of training components, parameters, and delivery formats will be essential in establishing the precise approaches needed to maximize cognitive outcomes. Novel studies using patient-level clinical and neuroimaging features to predict individual differences in training gains may inform the development of personalized intervention prescriptions to optimize cognitive health in late life.
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24
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Sanchez-Lara E, Lozano-Ruiz A, Perez-Garcia M, Caracuel A. Efficacy of mindfulness-based interventions in cognitive function in the elderly people: a systematic review and meta-analysis. Aging Ment Health 2022; 26:1699-1709. [PMID: 34587844 DOI: 10.1080/13607863.2021.1976724] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The main objective was to determine the efficacy of Mindfulness-Based Interventions in improving the cognitive function of older adults (healthy adults or adults with mild cognitive impairment). METHODS A search was conducted in 4 databases. The effect sizes were extracted to perform a meta-analysis of the cognitive functions, as well as subgroup meta-analyses according to each domain: attention, memory and executive function. RESULTS The meta-analysis of cognitive functions showed an average effect size of g = .07, 95% CI [-.013; .160], p = .09, with the following values for each domain: g = .02, 95% CI [-.167; .204] for attention; g = .06, 95% CI [-.148; .262] for memory; and g = .14, 95% CI [-.042; .329] for executive function. CONCLUSION The MBI had a null global effect. The attention and memory results showed a null effect size and a small effect size was found for executive function. The methodological quality of the studies, however, was poor, so the results need to be interpreted with caution.
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Affiliation(s)
| | - Alvaro Lozano-Ruiz
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Department of Personality, Evaluation, and Psychological Treatment, University of Granada, Granada, Spain
| | - Miguel Perez-Garcia
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Department of Personality, Evaluation, and Psychological Treatment, University of Granada, Granada, Spain
| | - Alfonso Caracuel
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
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25
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He Z, Tian S, Singh A, Chakraborty S, Zhang S, Lustria MLA, Charness N, Roque NA, Harrell ER, Boot WR. A Machine-Learning Based Approach for Predicting Older Adults' Adherence to Technology-Based Cognitive Training. Inf Process Manag 2022; 59:103034. [PMID: 35909793 PMCID: PMC9337718 DOI: 10.1016/j.ipm.2022.103034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adequate adherence is a necessary condition for success with any intervention, including for computerized cognitive training designed to mitigate age-related cognitive decline. Tailored prompting systems offer promise for promoting adherence and facilitating intervention success. However, developing adherence support systems capable of just-in-time adaptive reminders requires understanding the factors that predict adherence, particularly an imminent adherence lapse. In this study we built machine learning models to predict participants' adherence at different levels (overall and weekly) using data collected from a previous cognitive training intervention. We then built machine learning models to predict adherence using a variety of baseline measures (demographic, attitudinal, and cognitive ability variables), as well as deep learning models to predict the next week's adherence using variables derived from training interactions in the previous week. Logistic regression models with selected baseline variables were able to predict overall adherence with moderate accuracy (AUROC: 0.71), while some recurrent neural network models were able to predict weekly adherence with high accuracy (AUROC: 0.84-0.86) based on daily interactions. Analysis of the post hoc explanation of machine learning models revealed that general self-efficacy, objective memory measures, and technology self-efficacy were most predictive of participants' overall adherence, while time of training, sessions played, and game outcomes were predictive of the next week's adherence. Machine-learning based approaches revealed that both individual difference characteristics and previous intervention interactions provide useful information for predicting adherence, and these insights can provide initial clues as to who to target with adherence support strategies and when to provide support. This information will inform the development of a technology-based, just-in-time adherence support systems.
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Affiliation(s)
- Zhe He
- School of Information, Florida State University, Tallahassee, Florida USA
- College of Medicine, Florida State University, Tallahassee, Florida USA
| | - Shubo Tian
- Department of Statistics, Florida State University, Tallahassee, Florida USA
| | - Ankita Singh
- Department of Computer Science, Florida State University, Tallahassee, Florida USA
| | - Shayok Chakraborty
- Department of Computer Science, Florida State University, Tallahassee, Florida USA
| | - Shenghao Zhang
- Department of Psychology, Florida State University, Tallahassee, Florida USA
| | - Mia Liza A. Lustria
- School of Information, Florida State University, Tallahassee, Florida USA
- College of Medicine, Florida State University, Tallahassee, Florida USA
| | - Neil Charness
- Department of Psychology, Florida State University, Tallahassee, Florida USA
| | - Nelson A. Roque
- Department of Psychology, University of Central Florida, Orlando, Florida USA
| | - Erin R. Harrell
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama USA
| | - Walter R. Boot
- Department of Psychology, Florida State University, Tallahassee, Florida USA
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26
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Brill E, Krebs C, Falkner M, Peter J, Henke K, Züst M, Minkova L, Brem AK, Klöppel S. Can a serious game-based cognitive training attenuate cognitive decline related to Alzheimer's disease? Protocol for a randomized controlled trial. BMC Psychiatry 2022; 22:552. [PMID: 35962371 PMCID: PMC9373273 DOI: 10.1186/s12888-022-04131-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a major public health issue. Cognitive interventions such as computerized cognitive trainings (CCT) are effective in attenuating cognitive decline in AD. However, in those at risk of dementia related to AD, results are heterogeneous. Efficacy and feasibility of CCT needs to be explored in depth. Moreover, underlying mechanisms of CCT effects on the three cognitive domains typically affected by AD (episodic memory, semantic memory and spatial abilities) remain poorly understood. METHODS In this bi-centric, randomized controlled trial (RCT) with parallel groups, participants (planned N = 162, aged 60-85 years) at risk for AD and with at least subjective cognitive decline will be randomized to one of three groups. We will compare serious game-based CCT against a passive wait list control condition and an active control condition (watching documentaries). Training will consist of daily at-home sessions for 10 weeks (50 sessions) and weekly on-site group meetings. Subsequently, the CCT group will continue at-home training for an additional twenty-weeks including monthly on-site booster sessions. Investigators conducting the cognitive assessments will be blinded. Group leaders will be aware of participants' group allocations. Primarily, we will evaluate change using a compound value derived from the comprehensive cognitive assessment for each of three cognitive domains. Secondary, longitudinal functional and structural magnetic resonance imaging (MRI) and evaluation of blood-based biomarkers will serve to investigate neuronal underpinnings of expected training benefits. DISCUSSION The present study will address several shortcomings of previous CCT studies. This entails a comparison of serious game-based CCT with both a passive and an active control condition while including social elements crucial for training success and adherence, the combination of at-home and on-site training, inclusion of booster sessions and assessment of physiological markers. Study outcomes will provide information on feasibility and efficacy of serious game-based CCT in older adults at risk for AD and will potentially generalize to treatment guidelines. Moreover, we set out to investigate physiological underpinnings of CCT induced neuronal changes to form the grounds for future individually tailored interventions and neuro-biologically informed trainings. TRIAL REGISTRATION This RCT was registered 1st of July 2020 at clinicaltrials.gov (Identifier NCT04452864).
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Affiliation(s)
- Esther Brill
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Christine Krebs
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Michael Falkner
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Jessica Peter
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Katharina Henke
- Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Marc Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lora Minkova
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
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27
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Butz M, Gerriets T, Sammer G, El-Shazly J, Tschernatsch M, Huttner HB, Braun T, Boening A, Mengden T, Choi YH, Schoenburg M, Juenemann M. Effects of postoperative cognitive training on neurocognitive decline after heart surgery: A randomized clinical trial. Eur J Cardiothorac Surg 2022; 62:6567628. [PMID: 35415742 DOI: 10.1093/ejcts/ezac251] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/25/2022] [Accepted: 04/08/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Following cardiac surgery, postoperative cognitive decline (POCD) is a common complication that can impair quality of life and increase mortality. The aim of this study was to investigate whether early postoperative cognitive training can decrease POCD after cardiac surgery. METHODS The study was a multi-centered, 2-arm, randomized (1:1 ratio), controlled trial involving older patients undergoing elective heart valve surgery with extracorporeal circulation. Recruitment took place at the Departments of Cardiac Surgery of the Kerckhoff-Clinic in Bad Nauheim (Germany) and the University-Hospital in Giessen (Germany). The patients were randomized to either a paper-and-pencil-based cognitive training group or a standard rehabilitation care control group. The cognitive training started 1 week after surgery and lasted about 3 weeks until discharge from rehabilitation. To detect POCD, neuropsychological functions were assessed prior to surgery, upon discharge from rehabilitation (primary outcome), and 3 months after discharge (secondary outcome). Data were primarily analyzed in a per-protocol fashion. RESULTS The frequency of POCD at discharge from rehabilitation (training group, n = 37; control group, n = 44) was 50% in the control group and 19% in the training group (χ2[1]=8.45, p = 0.004; OR = 4.29, 95% CI [1.56-11.80]). Three months after the cognitive training (training group, n = 33; control group, n = 34), POCD frequency was 29% in the control group and 6% in the training group (χ2[1]=6.21, p = 0.013; OR = 6.46, 95% CI [1.29-32.28]). CONCLUSIONS Since our cognitive training showed beneficial effects, it could be a promising method to prevent POCD.
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Affiliation(s)
- Marius Butz
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany.,Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany
| | - Tibo Gerriets
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany.,Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany
| | - Gebhard Sammer
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany.,Cognitive Neuroscience at the Center of Psychiatry, University Giessen, Klinikstraße 36, 35385, Giessen, Germany.,Department of Psychology, Justus-Liebig University, Otto-Behaghel-Strasse 10, 35392, Giessen, Germany
| | - Jasmin El-Shazly
- Department of Psychocardiology, Kerckhoff Heart and Thorax Center, Ludwigstraße 41, 61231, Bad Nauheim, Germany
| | - Marlene Tschernatsch
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany.,Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany
| | - Hagen B Huttner
- Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany
| | - Tobias Braun
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany.,Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany
| | - Andreas Boening
- Department of Cardiovascular Surgery, University Hospital Giessen and Marburg, Rudolf-Buchheim-Straße 7, 35385, Giessen, Germany
| | - Thomas Mengden
- Department of Rehabilitation, Kerckhoff Heart and Thorax Center, Ludwigstraße 41, 61231, Bad Nauheim, Germany
| | - Yeong-Hoon Choi
- Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany
| | - Markus Schoenburg
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany.,Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany
| | - Martin Juenemann
- Heart and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestraße 2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany.,Department of Neurology, University Hospital Giessen and Marburg, Klinikstraße 33, 35385, Giessen, Germany
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28
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Rieker JA, Reales JM, Muiños M, Ballesteros S. The Effects of Combined Cognitive-Physical Interventions on Cognitive Functioning in Healthy Older Adults: A Systematic Review and Multilevel Meta-Analysis. Front Hum Neurosci 2022; 16:838968. [PMID: 35399365 PMCID: PMC8987130 DOI: 10.3389/fnhum.2022.838968] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/17/2022] [Indexed: 12/26/2022] Open
Abstract
Research has shown that both physical exercise and cognitive training help to maintain cognition in older adults. The question is whether combined training might produce additive effects when the group comparisons are equated in terms of exercise intensity and modality. We conducted a systematic electronic search in MEDLINE, PsycInfo, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify relevant studies published up to February 2021. Seven hundred and eighty-three effect sizes were obtained from 50 published intervention studies, involving 6,164 healthy older adults, and submitted to a three-level meta-analysis. Results showed that combined training produced a small advantage in comparison to single cognitive training on executive functions, whereas both types of training achieved similar effects on attention, memory, language, processing speed, and global cognition. Combined training achieved higher training gains in balance than single physical training, indicating a transfer from cognitive training to balance. Performing cognitive and physical exercise simultaneously, and interactive training (e.g., exergames, square stepping) produced the largest gains in executive functions, speed, and global cognition, as well as the largest improvements in physical functions. Aerobic training was associated with higher effects in attention and fitness, whereas non-aerobic training produced larger effects in global cognition and balance. For all cognitive and physical outcomes, training resulted more advantageous when performed in a social context, even though individual training obtained similar results in balance as group training.Systematic Review Registration:www.crd.york.ac.uk/prospero/, identifier: CRD42020175632.
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Affiliation(s)
- Jennifer A. Rieker
- Studies on Aging and Neurodegenerative Diseases Research Group, Madrid, Spain
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - José M. Reales
- Studies on Aging and Neurodegenerative Diseases Research Group, Madrid, Spain
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Mónica Muiños
- Studies on Aging and Neurodegenerative Diseases Research Group, Madrid, Spain
- Universidad Internacional de Valencia (VIU), Valencia, Spain
| | - Soledad Ballesteros
- Studies on Aging and Neurodegenerative Diseases Research Group, Madrid, Spain
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- *Correspondence: Soledad Ballesteros
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29
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Yang FPG, Liu TY, Liu CH, Murakami S, Nakai T. Verbal Training Induces Enhanced Functional Connectivity in Japanese Healthy Elderly Population. Front Hum Neurosci 2022; 16:786853. [PMID: 35308607 PMCID: PMC8930077 DOI: 10.3389/fnhum.2022.786853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
This study employs fMRI to examine the neural substrates of response to cognitive training in healthy old adults. Twenty Japanese healthy elders participated in a 4-week program and practiced a verbal articulation task on a daily basis. Functional connectivity analysis revealed that in comparison to age- and education-matched controls, elders who received the cognitive training demonstrated increased connectivity in the frontotemporal regions related with language and memory functions and showed significant correlations between the behavioral change in a linguistic task and connectivity in regions for goal-oriented persistence and lexical processing. The increased hippocampal connectivity was consistent with previous research showing efficacious memory improvement and change in hippocampal functioning. Moreover, the increased intra-network connectivity following cognitive training suggested an improved neural differentiation, in contrast to the inter-network activation pattern typical in the aging brain. This research not only validates the relationship of functional change in the frontal and temporal lobes to age-associated cognitive decline but also shows promise in turning neural change toward the right direction by cognitive training.
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Affiliation(s)
- Fan-Pei Gloria Yang
- Department of Foreign Languages and Literature, National Tsing Hua University, Hsinchu, Taiwan
- Center for Cognition and Mind Sciences, National Tsing Hua University, Hsinchu, Taiwan
- Department of Radiology, Graduate School of Dentistry, Osaka University, Suita, Japan
- *Correspondence: Fan-Pei Gloria Yang,
| | - Tzu-Yu Liu
- Department of Foreign Languages and Literature, National Tsing Hua University, Hsinchu, Taiwan
- Center for Cognition and Mind Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Chih-Hsuan Liu
- Department of Foreign Languages and Literature, National Tsing Hua University, Hsinchu, Taiwan
- Center for Cognition and Mind Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Shumei Murakami
- Department of Radiology, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Toshiharu Nakai
- Department of Radiology, Graduate School of Dentistry, Osaka University, Suita, Japan
- Institute of NeuroImaging and Informatics, Obu, Japan
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Campion J, Javed A, Lund C, Sartorius N, Saxena S, Marmot M, Allan J, Udomratn P. Public mental health: required actions to address implementation failure in the context of COVID-19. Lancet Psychiatry 2022; 9:169-182. [PMID: 35065723 PMCID: PMC8776278 DOI: 10.1016/s2215-0366(21)00199-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/19/2021] [Accepted: 05/14/2021] [Indexed: 12/13/2022]
Abstract
Mental disorders account for at least 18% of global disease burden, and the associated annual global costs are projected to be US$6 trillion by 2030. Evidence-based, cost-effective public mental health (PMH) interventions exist to prevent mental disorders from arising, prevent associated impacts of mental disorders (including through treatment), and promote mental wellbeing and resilience. However, only a small proportion of people with mental disorders receive minimally adequate treatment. Compared with treatment, there is even less coverage of interventions to prevent the associated impacts of mental disorders, prevent mental disorders from arising, or promote mental wellbeing and resilience. This implementation failure breaches the right to health, has increased during the COVID-19 pandemic, and results in preventable suffering, broad impacts, and associated economic costs. In this Health Policy paper, we outline specific actions to improve the coverage of PMH interventions, including PMH needs assessments, collaborative advocacy and leadership, PMH practice to inform policy and implementation, training and improvement of population literacy, settings-based and integrated approaches, use of digital technology, maximising existing resources, focus on high-return interventions, human rights approaches, legislation, and implementation research. Increased interest in PMH in populations and governments since the onset of the COVID-19 pandemic supports these actions. Improved implementation of PMH interventions can result in broad health, social, and economic impacts, even in the short-term, which support the achievement of a range of policy objectives, sustainable economic development, and recovery.
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Affiliation(s)
- Jonathan Campion
- South London and Maudsley NHS Foundation Trust, London, UK; Public Mental Health Implementation Centre, Royal College of Psychiatrists, London, UK.
| | - Afzal Javed
- Department of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Crick Lund
- King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Shekhar Saxena
- Department of Global Health and Population at the Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Michael Marmot
- Institute of Health Equity, Department of Epidemiology and Public Health, UCL, London, UK
| | - John Allan
- Office of the President, Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia; Mental Health, Alcohol and Other Drugs Branch, Clinical Excellence Queensland, Queensland Health, Brisbane, QLD, Australia; Mayne Academy of Psychiatry, University of Queensland Medical School, University of Queensland, Brisbane, QLD, Australia
| | - Pichet Udomratn
- Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Rengel KF, Boncyk CS, Hughes CG. Postoperative Delirium Prevention and Novel Cognitive Therapy Interventions. CURRENT ANESTHESIOLOGY REPORTS 2022. [DOI: 10.1007/s40140-021-00501-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wang H, Labus JS, Griffin F, Gupta A, Bhatt RR, Sauk JS, Turkiewicz J, Bernstein CN, Kornelsen J, Mayer EA. Functional brain rewiring and altered cortical stability in ulcerative colitis. Mol Psychiatry 2022; 27:1792-1804. [PMID: 35046525 PMCID: PMC9095465 DOI: 10.1038/s41380-021-01421-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/04/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022]
Abstract
Despite recent advances, there is still a major need to better understand the interactions between brain function and chronic gut inflammation and its clinical implications. Alterations in executive function have previously been identified in several chronic inflammatory conditions, including inflammatory bowel diseases. Inflammation-associated brain alterations can be captured by connectome analysis. Here, we used the resting-state fMRI data from 222 participants comprising three groups (ulcerative colitis (UC), irritable bowel syndrome (IBS), and healthy controls (HC), N = 74 each) to investigate the alterations in functional brain wiring and cortical stability in UC compared to the two control groups and identify possible correlations of these alterations with clinical parameters. Globally, UC participants showed increased functional connectivity and decreased modularity compared to IBS and HC groups. Regionally, UC showed decreased eigenvector centrality in the executive control network (UC < IBS < HC) and increased eigenvector centrality in the visual network (UC > IBS > HC). UC also showed increased connectivity in dorsal attention, somatomotor network, and visual networks, and these enhanced subnetwork connectivities were able to distinguish UC participants from HCs and IBS with high accuracy. Dynamic functional connectome analysis revealed that UC showed enhanced cortical stability in the medial prefrontal cortex (mPFC), which correlated with severe depression and anxiety-related measures. None of the observed brain changes were correlated with disease duration. Together, these findings are consistent with compromised functioning of networks involved in executive function and sensory integration in UC.
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Affiliation(s)
- Hao Wang
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA ,grid.54549.390000 0004 0369 4060Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu, 611731 P. R. China
| | - Jennifer S. Labus
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Fiona Griffin
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Arpana Gupta
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Ravi R. Bhatt
- grid.42505.360000 0001 2156 6853Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School Medicine at USC, University of Southern California, 4676 Admiralty Way, Marina Del Rey, CA 90292 USA
| | - Jenny S. Sauk
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Joanna Turkiewicz
- grid.266093.80000 0001 0668 7243University of California, Irvine School of Medicine, Irvine, CA 92697 USA
| | - Charles N. Bernstein
- grid.21613.370000 0004 1936 9609University of Manitoba IBD Clinical and Research Centre, Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Jennifer Kornelsen
- grid.21613.370000 0004 1936 9609University of Manitoba IBD Clinical and Research Centre, Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Emeran A. Mayer
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
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Turunen KM, Tirkkonen A, Savikangas T, Hänninen T, Alen M, Fielding RA, Kivipelto M, Stigsdotter Neely A, Törmäkangas T, Sipilä S. Effects of Physical and Cognitive Training on Falls and Concern about Falling in Older Adults: Results from a Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2021; 77:1430-1437. [PMID: 34910809 PMCID: PMC9255687 DOI: 10.1093/gerona/glab375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 12/01/2022] Open
Abstract
Background The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Methods This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70–85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cognitive training. The outcome was the rate of falls over the 12-month intervention (PTCT, n = 151 and PT, n = 155) and 12-month postintervention follow-up (PTCT, n = 143 and PT, n = 148). Falls were ascertained from monthly diaries. Exploratory outcomes included the rate of injurious falls, faller/recurrent faller/fall-related fracture status, and concern about falling. Results Estimated incidence rates of falls per person-year were 0.8 (95% confidence interval [CI] 0.7–1.1) in the PTCT and 1.1 (95% CI 0.9–1.3) in the PT during the intervention and 0.8 (95% CI 0.7–1.0) versus 1.0 (95% CI 0.8–1.1), respectively, during the postintervention follow-up. There was no significant difference in the rate of falls during the intervention (incidence rate ratio [IRR] = 0.78; 95% CI 0.56–1.10, p = .152) or in the follow-up (IRR = 0.83; 95% CI 0.59–1.15, p = .263). No significant between-group differences were observed in any exploratory outcomes. Conclusion A yearlong PTCT intervention did not result in a significantly lower rate of falls or concern about falling than PT alone in older community-dwelling adults. Clinical Trial Registration ISRCTN52388040
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Affiliation(s)
- Katri M Turunen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Seinäjoki University of Applied Sciences, School of Health Care and Social Work, Seinäjoki, Finland
| | - Anna Tirkkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiina Savikangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuomo Hänninen
- NeuroCenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Markku Alen
- Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Miia Kivipelto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Anna Stigsdotter Neely
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.,Department of Psychology, Umeå University, Umeå, Sweden
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Roheger M, Kalbe E, Corbett A, Brooker H, Ballard C. Predictors of activities of daily living in heathy older adults: Who benefits most from online cognitive training? Brain Behav 2021; 11:e2388. [PMID: 34661996 PMCID: PMC8613408 DOI: 10.1002/brb3.2388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the course of activities of daily living (IADL) functioning and possible predictors of performance changes in healthy older adults conducting either a General Cognitive Training (GCT) or a Reasoning Cognitive Training (ReaCT) or no training (control group, CG) over a period of 6 weeks, 3 months, and 6 months. SETTING AND PARTICIPANTS An online, home-based GCT and ReaCT including n = 2913 healthy participants (GCT: n = 1096; ReaCT: n = 1022; CG: n = 794) aged 60 years and older. METHODS Multilevel analysis were calculated to explore the nature of our outcome variables of IADL part A (independence) and part B (difficulty of tasks), and to detect possible predictors for participants' performance on IADL after CT. RESULTS The random slopes models fitted better for the outcomes IADL Part B in the GCT group (χ2 (2) = 18.78, p < .01), and both IADL Part A and Part B in the ReaCT group (χ2 (2) = 28.57, p < .01; χ2 (2) = 63.38, p < .01, respectively), indicating different changes over time for individual participants. Female sex was a significant predictor of IADL change in the ReaCT group, showing that females benefited most in both IADL scores (IADL A: 0.01, p < .01; IADL B: 0.004, p < .01). No other significant predictors for IADL changes were identified. CONCLUSION AND IMPLICATION The particular effectiveness in women is of clinical relevance, as IADL is typically more impaired in women than in men in advanced age. Following a personalized medicine approach, identifying predictors of non-pharmacological intervention success is of utmost importance.
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Affiliation(s)
- Mandy Roheger
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anne Corbett
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Helen Brooker
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Clive Ballard
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
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Yu RWL, Chan AHS. Meta-analysis of the effects of game types and devices on older adults-video game interaction: Implications for video game training on cognition. APPLIED ERGONOMICS 2021; 96:103477. [PMID: 34107433 DOI: 10.1016/j.apergo.2021.103477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 06/12/2023]
Abstract
Video game training can effectively improve the cognition of older adults. However, whether video game types and game devices influence the training effects of video games remains controversial. This meta-analysis aimed to access and evaluate the effects of video game types and game devices in video game training on the cognition of older adults. Interestingly, results indicated that mouse/keyboard was superior over other video game devices on perceptual-motor function. The effect size (Hedge's g) for perceptual-motor function decreased by 1.777 and 1.722 when the video game training device changed from mouse/keyboard to driving simulator and motion controller. The effects of cognitive training game and conventional video game were moderated by session length. More well-designed studies are required to clarify the unique efficacy of video game types and devices for older adults with video game training.
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Affiliation(s)
- Rita Wing Lam Yu
- Department of Advanced Design and Systems Engineering, City University of Hong Kong, Kowloon, Hong Kong.
| | - Alan Hoi Shou Chan
- Department of Advanced Design and Systems Engineering, City University of Hong Kong, Kowloon, Hong Kong.
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PARK JINHYUCK. CAN COGNITIVE TRAINING USING A TABLET COMPUTER ENHANCE COGNITIVE FUNCTION OF HEALTHY OLDER ADULTS? AN ALTERNATING-TREATMENT DESIGN. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421400443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Even though a variety of cognitive interventions have been conducted to ameliorate age-related cognitive declines, the effects of cognitive intervention using activities in everyday life are still unknown. The purpose of this study was to compare the effects between tablet computer-based productive and receptive cognitive engagement using an alternating-treatment design. Three healthy older adults performed a total of 19 sessions consisting of three baseline periods and 16 alternating training sessions. The training sessions were divided into four blocks and each block involved four treatment sessions. Productive and receptive engagements were randomly allocated to four treatment sessions. All participants alternatively received productive engagement that requires learning new practical applications and receptive engagement requiring little new learning such as listening to music. Prefrontal cortex (PFC) activity using functional near-infrared spectroscopy and executive function through the Trail Making Test were assessed at the baseline and the end of each session. All data were visually analyzed. Visual analysis results showed that the productive engagement was associated with higher PFC activity and faster performance in the Trail Making Test, compared to those utilizing receptive engagement. These results suggest that productive engagement might be effective in facilitating PFC activity and improving the executive function of healthy older adults, indicating cognitively challenging activities are more beneficial relative to nonchallenging activities.
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Affiliation(s)
- JIN-HYUCK PARK
- College of Medical Science, Soonchunhyang University, Soonchunhyang-ro 22-20, Republic of Korea
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Blancafort Alias S, Cuevas-Lara C, Martínez-Velilla N, Zambom-Ferraresi F, Soto ME, Tavassoli N, Mathieu C, Heras Muxella E, Garibaldi P, Anglada M, Amblàs J, Santaeugènia S, Contel JC, Domingo À, Salvà Casanovas A. A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5979. [PMID: 34199566 PMCID: PMC8199683 DOI: 10.3390/ijerph18115979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/30/2022]
Abstract
The World Health Organization has developed the Integrated Care of Older People (ICOPE) strategy, a program based on the measurement of intrinsic capacity (IC) as "the composite of all physical and mental attributes on which an individual can draw". Multicomponent interventions appear to be the most effective approach to enhance IC and to prevent frailty and disability since adapted physical activity is the preventive intervention that has shown the most evidence in the treatment of frailty and risk of falls. Our paper describes the development of a multi-domain group-based intervention addressed to older people living in the community, aimed at improving and/or maintaining intrinsic capacity by means of promoting physical activity, healthy nutrition, and psychological wellbeing in older people. The process of intervention development is described following the Guidance for reporting intervention development studies in health research (GUIDED). The result of this study is the AMICOPE intervention (Aptitude Multi-domain group-based intervention to improve and/or maintain IC in Older PEople) built upon the ICOPE framework and described following the Template for Intervention Description and Replication (TIDieR) guidelines. The intervention consists of 12 face-to-face sessions held weekly for 2.5 h over three months and facilitated by a pair of health and social care professionals. This study represents the first stage of the UK Medical Research Council framework for developing and evaluating a complex intervention. The next step should be carrying out a feasibility study for the AMICOPE intervention and, at a later stage, assessing the effectiveness in a randomized controlled trial.
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Affiliation(s)
- Sergi Blancafort Alias
- Fundació Salut i Envelliment (Foundation on Health and Ageing)—UAB, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (À.D.); (A.S.C.)
| | - César Cuevas-Lara
- Navarrabiomed, Geriatrics Department, Hospital Complex of Navarra (CHN)—Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), 31008 Pamplona, Spain; (C.C.-L.); (N.M.-V.); (F.Z.-F.)
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Geriatrics Department, Hospital Complex of Navarra (CHN)—Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), 31008 Pamplona, Spain; (C.C.-L.); (N.M.-V.); (F.Z.-F.)
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Geriatrics Department, Hospital Complex of Navarra (CHN)—Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), 31008 Pamplona, Spain; (C.C.-L.); (N.M.-V.); (F.Z.-F.)
| | - Maria Eugenia Soto
- Equipe Régional Vieillissement et Prévention de la Dépendance, Gérontopôle, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (M.E.S.); (N.T.); (C.M.)
| | - Neda Tavassoli
- Equipe Régional Vieillissement et Prévention de la Dépendance, Gérontopôle, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (M.E.S.); (N.T.); (C.M.)
| | - Céline Mathieu
- Equipe Régional Vieillissement et Prévention de la Dépendance, Gérontopôle, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (M.E.S.); (N.T.); (C.M.)
| | - Eva Heras Muxella
- Ageing and Health Department in the Andorran Healthcare System, Servei Andorrà d’Atenció Sanitaria, AD700 Escaldes-Engordany, Andorra; (E.H.M.); (P.G.); (M.A.)
| | - Pablo Garibaldi
- Ageing and Health Department in the Andorran Healthcare System, Servei Andorrà d’Atenció Sanitaria, AD700 Escaldes-Engordany, Andorra; (E.H.M.); (P.G.); (M.A.)
| | - Maria Anglada
- Ageing and Health Department in the Andorran Healthcare System, Servei Andorrà d’Atenció Sanitaria, AD700 Escaldes-Engordany, Andorra; (E.H.M.); (P.G.); (M.A.)
| | - Jordi Amblàs
- Chronic Care Program, Department of Health, Generalitat de Catalunya, 08028 Barcelona, Spain; (J.A.); (S.S.); (J.C.C.)
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic/Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - Sebastià Santaeugènia
- Chronic Care Program, Department of Health, Generalitat de Catalunya, 08028 Barcelona, Spain; (J.A.); (S.S.); (J.C.C.)
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic/Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - Joan Carles Contel
- Chronic Care Program, Department of Health, Generalitat de Catalunya, 08028 Barcelona, Spain; (J.A.); (S.S.); (J.C.C.)
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic/Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - Àlex Domingo
- Fundació Salut i Envelliment (Foundation on Health and Ageing)—UAB, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (À.D.); (A.S.C.)
| | - Antoni Salvà Casanovas
- Fundació Salut i Envelliment (Foundation on Health and Ageing)—UAB, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (À.D.); (A.S.C.)
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Estrada-Plana V, Montanera R, Ibarz-Estruga A, March-Llanes J, Vita-Barrull N, Guzmán N, Ros-Morente A, Ayesa Arriola R, Moya-Higueras J. Cognitive training with modern board and card games in healthy older adults: two randomized controlled trials. Int J Geriatr Psychiatry 2021; 36:839-850. [PMID: 33275804 DOI: 10.1002/gps.5484] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/29/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The aim of this study was to assess the effectiveness of a cognitive intervention based on modern board and card games. METHODS We conducted two two-arm parallel-group, randomized controlled trials. The first one (pilot study) was nonblind. The second one (main study) was a double-blind design. Participants (14 in a pilot study and 35 in the main study) were healthy older adults over 65 years old who were assisting to adult care institutions. In the pilot study, participants in the experimental group (n = 6) played modern board and card games which activated cognitive processes; whereas the control group (n = 6) was in the wait-list condition. In the main study, participants in the experimental group (n = 12) also played modern board and card games; whereas the control group (n = 15) performed standardized paper-and-pencil cognitive tasks. Psychologists specialized in older-people conducted all the interventions. In both studies, intervention sessions were bi-weekly for 5 weeks. The outcomes of both studies were cognitive status and executive functioning, depressive symptomatology, and quality of life measures. All assessment and intervention sessions took place in their habitual centers. RESULTS In the pilot study, participants in the games intervention showed a significant improvement in semantic verbal fluency. In the main study, both interventions showed significant improvements in phonemic verbal fluency. Whilst board and card games maintained motor impulsivity control, paper-and-pencil tasks improved speed in an inhibition task. CONCLUSIONS Modern board and card games could be an effective cognitive intervention to maintain some cognitive functions.
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Affiliation(s)
| | - Roger Montanera
- Department of Psychology, University of Lleida, Lleida, Spain.,Residencia Comtes Urgell, Balaguer, Spain
| | | | | | | | | | | | - Rosa Ayesa Arriola
- Department of Psychiatry, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.,Center for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Moya-Higueras
- Department of Psychology, University of Lleida, Lleida, Spain.,Center for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Lisko I, Kulmala J, Annetorp M, Ngandu T, Mangialasche F, Kivipelto M. How can dementia and disability be prevented in older adults: where are we today and where are we going? J Intern Med 2021; 289:807-830. [PMID: 33314384 PMCID: PMC8248434 DOI: 10.1111/joim.13227] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age-related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle-based intervention can prevent cognitive and functional decline amongst at-risk older adults from the general population. Within the World-Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self-management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.
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Affiliation(s)
- I. Lisko
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Faculty of Sport and Health Sciences and Gerontology Research CenterUniversity of JyväskyläJyväskyläFinland
| | - J. Kulmala
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
- School of Health Care and Social WorkSeinäjoki University of Applied SciencesSeinäjokiFinland
| | - M. Annetorp
- Karolinska University Hospital, Theme AgingStockholmSweden
| | - T. Ngandu
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
| | - F. Mangialasche
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Aging Research CenterDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - M. Kivipelto
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Karolinska University Hospital, Theme AgingStockholmSweden
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandHelsinkiFinland
- Ageing and Epidemiology (AGE) Research UnitSchool of Public HealthImperial College LondonLondonUK
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Increasing autonomy through improved care: effects of a professional care-giver training programme on the functional status of older adults. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The aim of the present research was to evaluate the effectiveness of a care-giver training programme that trains professional care-givers in cognitive stimulation strategies for functional maintenance in care-dependent older adults. The sample contained 69 older adults (37 in the treatment group, 32 control group) assessed with the Barthel Index, the Mini-Mental State Examination and the Clifton Assessment Procedure for the Elderly (Cognitive Scale). Participants in the treatment group were treated by professional care-givers who were trained with the programme CUIDA-2 in communication and cognitive stimulation strategies. The results from the Barthel Index showed significant differences in the post-intervention assessment and in the follow-up assessment, where the treatment group obtained higher scores, and there were significant differences within the treatment group between the initial assessment and the post-treatment assessment, as well as between the initial assessment and the follow-up. The data obtained reflect that a training programme to train professional care-givers produced functional benefits in the older adults, and these improvements persisted over time. Moreover, the care-givers saw themselves as more competent and more satisfied with their work.
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41
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Duggan MR, Parikh V. Microglia and modifiable life factors: Potential contributions to cognitive resilience in aging. Behav Brain Res 2021; 405:113207. [PMID: 33640394 PMCID: PMC8005490 DOI: 10.1016/j.bbr.2021.113207] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/27/2021] [Accepted: 02/20/2021] [Indexed: 02/08/2023]
Abstract
Given the increasing prevalence of age-related cognitive decline, it is relevant to consider the factors and mechanisms that might facilitate an individual's resiliency to such deficits. Growing evidence suggests a preeminent role of microglia, the prime mediator of innate immunity within the central nervous system. Human and animal investigations suggest aberrant microglial functioning and neuroinflammation are not only characteristic of the aged brain, but also might contribute to age-related dementia and Alzheimer's Disease. Conversely, accumulating data suggest that modifiable lifestyle factors (MLFs), such as healthy diet, exercise and cognitive engagement, can reliably afford cognitive benefits by potentially suppressing inflammation in the aging brain. The present review highlights recent advances in our understanding of the role for microglia in maintaining brain homeostasis and cognitive functioning in aging. Moreover, we propose an integrated, mechanistic model that postulates an individual's resiliency to cognitive decline afforded by MLFs might be mediated by the mitigation of aberrant microglia activation in aging, and subsequent suppression of neuroinflammation.
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Affiliation(s)
- Michael R Duggan
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, 19122, United States
| | - Vinay Parikh
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, 19122, United States.
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42
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Roheger M, Liebermann-Jordanidis H, Krohm F, Adams A, Kalbe E. Prognostic Factors and Models for Changes in Cognitive Performance After Multi-Domain Cognitive Training in Healthy Older Adults: A Systematic Review. Front Hum Neurosci 2021; 15:636355. [PMID: 33986652 PMCID: PMC8110835 DOI: 10.3389/fnhum.2021.636355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/26/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Cognitive Training (CT) may contribute to the maintenance and even enhancement of cognitive functions in healthy older adults. However, the question who benefits most from multi-domain CTs is still highly under-investigated. Objective: The goal is to investigate prognostic factors and models for changes in cognitive test performance in healthy older adults after a multi-domain CT. Methods: The data bases MEDLINE, Web of Science Core Collection, CENTRAL, and PsycInfo were searched up to July 2019. Studies investigating prognostic factors and/or models on cognitive outcomes (global cognition, memory, attention, executive functions, language, visuo-spatial abilities) after conducting a multi-domain CT in healthy older adults were included. Risk of Bias was assessed using the QUIPS and the PROBAST tool. Results: 23 prognostic factor and model studies were included. Results indicate a high heterogeneity regarding the conducted multi-domain CTs, the investigated prognostic factors, the investigated outcomes, and the used statistical approaches. Age and neuropsychological performance at study entry were the most investigated predictors, yet they show inconsistent results. Conclusion: Data on prognostic factors and models of changes after multi-domain CT are still too rare and inconsistent to draw clear conclusions due to statistical shortcomings and low reporting quality. Approaches for future research are outlined. Registration:https://www.crd.york.ac.uk/prospero/, ID: CRD42020147531
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Affiliation(s)
- Mandy Roheger
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany.,Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Hannah Liebermann-Jordanidis
- Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Fabian Krohm
- Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology
- Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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The Effect of Cognitive Intervention on Cognitive Function in Older Adults With Alzheimer's Disease: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 32:247-273. [PMID: 33893905 DOI: 10.1007/s11065-021-09486-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
Cognitive intervention includes cognitive stimulation, cognitive training, and cognitive rehabilitation. This systematic review was performed to re-assess the efficacy of cognitive intervention for the patients with Alzheimer's disease (AD). Twenty studies (2012 participants) were eventually included. For global cognitive function, the combined mean difference (MD) in eight studies was 1.67 (95% Confidence Interval: 0.45, 2.89, p = 0.007; Q = 33.28, df = 8, p < 0.0001, τ2 = 2.17, I2 = 76%) for the short term. The pooled standardized mean difference (SMD) of six RCTs was 1.61 (95% Confidence Interval: 0.65, 2.56, p = 0.0009; Q = 127.66, df = 6, p < 0.00001, τ2 = 1.56, I2 = 95%) for the medium term. The pooled SMD of seven studies was 0.79 (95% Confidence Interval: 0.33, 1.25, p = 0.0008; Q = 35.10, df = 7, p < 0.0001, τ2 = 0.33, I2 = 80%) for the long term. For depression, the pooled SMD of two trials was -0.48 (95% Confidence Interval: -0.71, -0.24; p < 0.0001, I2 = 4%) for the short term. Cognitive training may show obvious improvements in global cognitive function whether after short, medium, or long-term interventions and in depression after short term intervention. However, the positive effect of the intervention on general cognitive function or depression did not seem to persist after intervention ended. There is still a lack of reliable and consistent conclusions relevant to the effect of cognitive stimulation and cognitive rehabilitation on observed outcomes, cognitive training for memory or other non-cognitive outcomes. PROSPERO registration number: CRD42019121768.
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Ten Brinke LF, Hsu CL, Erickson KI, Handy TC, Liu-Ambrose T. Functional Connectivity and Response Inhibition: A Secondary Analysis of an 8-Week Randomized Controlled Trial of Computerized Cognitive Training. J Alzheimers Dis 2021; 80:1525-1537. [PMID: 33720882 DOI: 10.3233/jad-200844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence suggests that computerized cognitive training (CCT) can improve cognitive function in older adults, particularly executive functions. However, the underlying mechanisms by which CCT may improve executive functions are not well established. OBJECTIVE To determine: 1) inter-network functional connectivity correlates of changes in executive functions; and 2) the effect of CCT on these functional connectivity correlates. METHODS This secondary analysis included a subset of 124 adults aged 65-85 years enrolled in an 8-week randomized controlled trial of CCT. Participants were randomized to either: 1) group-based CCT 3x/week for 1 hour plus 3x/week home-based training; 2) group-based CCT preceded by brisk walking (Ex+CCT) 3x/week for 1 hour plus 3x/week home-based training; or 3) group-based balanced and toned (BAT) classes 3x/week for 1 hour (control). At baseline and trial completion, 65 of the 124 participants completed resting-state functional magnetic resonance imaging and neuropsychological tests of executive functions, specifically the Stroop Colour-Word Test and Flanker Test. RESULTS Improved performance on the Stroop Colour-Word Test and Flanker Test were associated with decreased correlation between the default mode network (DMN) and the fronto-parietal network (FPN) (p < 0.05). Compared with BAT, CCT alone significantly decreased correlation between the left dorsolateral prefrontal cortex and both the left and right medial temporal gyrus (-0.143, 95%CI [-0.256,-0.030], p = 0.014, and -0.123, 95%CI [-0.242,-0.004], p = 0.043, respectively). CONCLUSION Decreased correlation between DMN and FPN, indicating less connection between these networks, may be an underlying mechanism by which CCT improves executive functions. Future studies are needed to replicate this finding.
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Affiliation(s)
- Lisanne F Ten Brinke
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Todd C Handy
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
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45
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Computerized Cognitive Training: A Review of Mechanisms, Methodological Considerations, and Application to Research in Depression. JOURNAL OF COGNITIVE ENHANCEMENT 2021. [DOI: 10.1007/s41465-021-00209-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mikos A, Malagurski B, Liem F, Mérillat S, Jäncke L. Object-Location Memory Training in Older Adults Leads to Greater Deactivation of the Dorsal Default Mode Network. Front Hum Neurosci 2021; 15:623766. [PMID: 33716693 PMCID: PMC7952529 DOI: 10.3389/fnhum.2021.623766] [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: 10/30/2020] [Accepted: 01/20/2021] [Indexed: 12/02/2022] Open
Abstract
Substantial evidence indicates that cognitive training can be efficacious for older adults, but findings regarding training-related brain plasticity have been mixed and vary depending on the imaging modality. Recent years have seen a growth in recognition of the importance of large-scale brain networks on cognition. In particular, task-induced deactivation within the default mode network (DMN) is thought to facilitate externally directed cognition, while aging-related decrements in this neural process are related to reduced cognitive performance. It is not yet clear whether task-induced deactivation within the DMN can be enhanced by cognitive training in the elderly. We previously reported durable cognitive improvements in a sample of healthy older adults (age range = 60-75) who completed 6 weeks of process-based object-location memory training (N = 36) compared to an active control training group (N = 31). The primary aim of the current study is to evaluate whether these cognitive gains are accompanied by training-related changes in task-related DMN deactivation. Given the evidence for heterogeneity of the DMN, we examine task-related activation/deactivation within two separate DMN branches, a ventral branch related to episodic memory and a dorsal branch more closely resembling the canonical DMN. Participants underwent functional magnetic resonance imaging (fMRI) while performing an untrained object-location memory task at four time points before, during, and after the training period. Task-induced (de)activation values were extracted for the ventral and dorsal DMN branches at each time point. Relative to visual fixation baseline: (i) the dorsal DMN was deactivated during the scanner task, while the ventral DMN was activated; (ii) the object-location memory training group exhibited an increase in dorsal DMN deactivation relative to the active control group over the course of training and follow-up; (iii) changes in dorsal DMN deactivation did not correlate with task improvement. These results indicate a training-related enhancement of task-induced deactivation of the dorsal DMN, although the specificity of this improvement to the cognitive task performed in the scanner is not clear.
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Affiliation(s)
- Ania Mikos
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
| | - Brigitta Malagurski
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
| | - Franziskus Liem
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
| | - Lutz Jäncke
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
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Nouchi R, Hu Q, Saito T, Kawata NYDS, Nouchi H, Kawashima R. Brain Training and Sulforaphane Intake Interventions Separately Improve Cognitive Performance in Healthy Older Adults, Whereas a Combination of These Interventions Does Not Have More Beneficial Effects: Evidence from a Randomized Controlled Trial. Nutrients 2021; 13:nu13020352. [PMID: 33503851 PMCID: PMC7912304 DOI: 10.3390/nu13020352] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Earlier studies have demonstrated that a single-domain intervention, such as a brain-training (BT) game alone and a sulforaphane (SFN) intake, positively affects cognition. This study examined whether a combined BT and SFN intake intervention has beneficial effects on cognitive function in older adults. Methods: In a 12-week double-blinded randomized control trial, 144 older adults were randomly assigned to one of four groups: BT with SFN (BT-S), BT with placebo (BT-P), active control game (AT) with SFN (AT-S), and active control game with placebo (AT-P). We used Brain Age in BT and Tetris in AT. Participants were asked to play BT or AT for 15 min a day for 12 weeks while taking a supplement (SFN or placebo). We measured several cognitive functions before and after the intervention period. Results: The BT (BT-S and BT-P) groups showed more improvement in processing speed than the active control groups (AT-S and AT-P). The SFN intake (BT-S and AT-S) groups recorded significant improvements in processing speed and working memory performance unlike the placebo intake groups (BT-P and AT-P). However, we did not find any evidence of the combined intervention’s beneficial effects on cognition. Discussion: We discussed a mechanism to improve cognitive functions in the BT and SFN alone interventions.
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Affiliation(s)
- Rui Nouchi
- Department of Cognitive Health Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan;
- Smart Aging Research Center (S.A.R.C.), Tohoku University, Seiryo-Machi 4-1, Sendai 980-8575, Japan;
- Correspondence:
| | - Qingqiang Hu
- Nature and Wellness Research Department, Innovation Division, Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara 329-2762, Japan;
| | - Toshiki Saito
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan; (T.S.); (N.Y.d.S.K.)
| | - Natasha Yuriko dos Santos Kawata
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan; (T.S.); (N.Y.d.S.K.)
| | - Haruka Nouchi
- Department of Cognitive Health Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan;
| | - Ryuta Kawashima
- Smart Aging Research Center (S.A.R.C.), Tohoku University, Seiryo-Machi 4-1, Sendai 980-8575, Japan;
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan; (T.S.); (N.Y.d.S.K.)
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Ten Brinke LF, Best JR, Chan JLC, Ghag C, Erickson KI, Handy TC, Liu-Ambrose T. The Effects of Computerized Cognitive Training With and Without Physical Exercise on Cognitive Function in Older Adults: An 8-Week Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2021; 75:755-763. [PMID: 31054254 DOI: 10.1093/gerona/glz115] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Aging is characterized by cognitive changes in specific domains, such as declines in memory and executive functions. Given the world's aging population, it is important to identify and evaluate strategies that promote healthy cognitive aging. Besides exercise, computerized cognitive training (CCT) is a promising approach to promote cognitive function. Moreover, a single bout of exercise immediately prior to CCT may provide additional cognitive benefits. METHODS An 8-week proof-of-concept randomized controlled trial to investigate the effect of a commercial CCT intervention, alone and when preceded by exercise, on cognitive function. Participants (124; aged 65-85 years) performed 8 weeks of: (i) Group-based CCT (Fit Brains) 3×/week for 1 hour plus 3×/week home-based training; (ii) Group-based CCT preceded by exercise (Ex-CCT) 3×/week for 1 hour plus 3×/week home-based training (exercise+CCT); or (iii) Group-based balanced and toned (BAT) classes 3×/week for 1 hour (control). Memory was assessed by the Rey Auditory Verbal Learning Test. Executive functions were assessed using the: (i) Stroop Test, (ii) Trail Making Tests (TMT), (iii) Flanker Test, and (iv) Dimensional Change Card Sort Test (DCCS). RESULTS At trial completion, there were no significant between-group differences in memory (p > .05). However, compared with BAT, CCT, and Ex-CCT significantly improved Stroop performance (-10.72, 95% confidence interval [CI]: -16.53, -4.91; -7.95, 95% CI: -13.77, -2.13, respectively). Moreover, Ex-CCT significantly improved the performance on TMT (-13.65, 95% CI: -26.09, -1.22), the Flanker Test (6.72, 95% CI: 2.55, 10.88), and the DCCS Test (6.75, 95% CI: 0.99, 12.50). CONCLUSION An 8-week CCT program may promote executive functions in older adults and combining it with a bout of exercise may provide broader benefits.
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Affiliation(s)
- Lisanne F Ten Brinke
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - Joey L C Chan
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - Cheyenne Ghag
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pennsylvania
| | - Todd C Handy
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, British Columbia, Canada
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Szabo-Reed AN, Donnelly JE. Cognitive Training: Associations and Implications for Weight Management and Translational Research. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021; 6. [PMID: 34017915 DOI: 10.1249/tjx.0000000000000151] [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] [Indexed: 11/21/2022]
Abstract
Behavioral weight loss programs combining energy restriction and increased physical activity (PA) are generally successful in producing clinically significant weight loss (≥5%) over 3-6 mos. However, weight maintenance (≥ 2 yrs.) continues to be problematic, due in part to an inability of individuals to continue adherence to diet and PA recommendations. It is hypothesized that neurocognitive processes, specifically executive functions (EFs, i.e., inhibition, working memory, mental flexibility), underlie self-regulation, self-efficacy, and are essential for the adoption and maintenance of health behaviors. Behavioral weight loss programs generally attempt to improve self-regulation; however, these skills are difficult to implement long-term. Strengthening EFs through cognitive training may improve weight maintenance by improving self-efficacy and self-regulation, resulting in improved program attendance and improved adherence to dietary and PA recommendations. Although randomized trials have not been conducted to specifically evaluate this hypothesis, results from the available literature suggest the potential for cognitive training to improve weight maintenance.
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Affiliation(s)
- Amanda N Szabo-Reed
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
| | - Joseph E Donnelly
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
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Gajewski PD, Thönes S, Falkenstein M, Wascher E, Getzmann S. Multidomain Cognitive Training Transfers to Attentional and Executive Functions in Healthy Older Adults. Front Hum Neurosci 2020; 14:586963. [PMID: 33304256 PMCID: PMC7701175 DOI: 10.3389/fnhum.2020.586963] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Healthy aging is associated with deficits in focused and sustained attention and executive functions. However, cognitive training (CT) provides a promising method to counteract these deficits. In the present randomized controlled study, we examined to what extent CT regimes can improve attention, verbal skills, and inhibition capacities. Over a period of 16 weeks, healthy older adults (65 years and older, mean: 70 years) received a trainer-guided multidomain paper-and-pencil and computerized CT. Pre- and post-training, a battery of psychometric tests was applied that measured the critical functions. This study used two control groups: a passive control and an active control group performing a relaxation training. Compared to a passive control group, the CT led to enhanced performance in the attentional endurance test and the interference list of the Stroop test, whereas no benefits in verbal and crystalized tests were found. Similar effects were found on the attentional endurance compared to the active control group. Additionally, word fluency was enhanced after CT, but the improvement in the Stroop test did not reach significance compared to the active control. The contents of CT were dissimilar to the psychometric tests showing far transfer, whereas no transfer to attentional or memory functions in the daily life assessed by the Cognitive Failures Questionnaire was found. This demonstrates specific gains of multidomain CT on cognitive functions not explicitly trained and lack of transfer to daily activities.
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Affiliation(s)
- Patrick D Gajewski
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - Sven Thönes
- Department of Psychology, University of Mainz, Dortmund, Germany
| | | | - Edmund Wascher
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - Stephan Getzmann
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
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