Effect of Speed of Processing Training on Older Driver Screening Measures

Multi-Domain Interventions for Dementia Prevention - A Systematic Review

OBJECTIVES

There is a growing incidence of cognitive decline and dementia associated with the ageing population. Lifestyle factors such as diet, physical activity, and cognitive activities may individually or collectively be undertaken to increase one's odds of preventing cognitive decline and future dementia. This study will examine whether clinical trials using multidomain lifestyle intervention can significantly decrease the risk of cognitive decline and therefore dementia.

DESIGN, SETTING AND PARTICIPANTS

This systematic literature review of multidomain lifestyle interventions for the prevention of cognitive decline and dementia followed the PRISMA guidelines. Clinical trials involving multidomain intervention (i.e., diet and physical activity, or without cognitive training) in older adults (≥ 49 years old) at higher risk of dementia were identified through 5 electronic databases (EMBASE, MEDLINE, CINAHL, Cochrane, and Scopus). A comprehensive search was performed to identify and retrieve publications until 15 November 2022. Trials were published in English.

RESULTS

The included studies (n=15) assessed change in cognition in response to a multidomain lifestyle intervention. However, the cognitive outcome measures used in these studies were heterogeneous. Despite this heterogeneity, two thirds of the studies showed improvement in cognition following a multidomain intervention (n=10 with a total of 9,439 participants). However, five studies reported no improvement in cognition following the multidomain intervention. The most common form of dietary intervention included higher amount of fruit and vegetable intake; whole-grain cereal products instead of refined; low fat options in milk and meat products; and limiting sucrose intake to less than 50 g/day. Most clinical trial studies were powered to examining the effects of multidomain interventions in cognition but were not designed to test the contribution of individual domains (i.e., dietary changes, increased physical activity, or increased cognitive stimulation alone).

CONCLUSION

This systematic review aimed to determine the effect of multimodal lifestyle interventions on cognitive outcomes in older adults at risk of dementia. We found that participants with conditions that may increase the risk of dementia, (e.g., hypertension, cardiovascular fragility) do benefit from multi-modal lifestyle changes including diet, physical activity, and cognitive training. Two thirds of studies using multidomain lifestyle interventions showed improvements in cognitive function. Trials with a focus on cognitive training, dietary improvement, and physical activity may prevent or delay cognitive decline in older adults including those at risk of developing dementia. Future studies should consider longer follow-up periods and adequate power to be able to examine the effects of each lifestyle component in the context of multimodal interventions.

Impact of Visual Game-Like Features on Cognitive Performance in a Virtual Reality Working Memory Task: Within-Subjects Experiment

BACKGROUND

Although the pursuit of improved cognitive function through working memory training has been the subject of decades of research, the recent growth in commercial adaptations of classic working memory tasks in the form of gamified apps warrants additional scrutiny. In particular, the emergence of virtual reality as a platform for cognitive training presents opportunities for the use of novel visual features.

OBJECTIVE

This study aimed to add to the body of knowledge regarding the use of game-like visual design elements by specifically examining the application of two particular visual features common to virtual reality environments: immersive, colorful backgrounds and the use of 3D depth. In addition, electroencephalography (EEG) data were collected to identify potential neural correlates of any observed changes in performance.

METHODS

A simple visual working memory task was presented to participants in several game-like adaptations, including the use of colorful, immersive backgrounds and 3D depth. The impact of each adaptation was separately assessed using both EEG and performance assessment outcomes and compared with an unmodified version of the task.

RESULTS

Results suggest that although accuracy and reaction time may be slightly affected by the introduction of such game elements, the effects were small and not statistically significant. Changes in EEG power, particularly in the beta and theta rhythms, were significant but failed to correlate with any corresponding changes in performance. Therefore, they may only reflect cognitive changes at the perceptual level.

CONCLUSIONS

Overall, the data suggest that the addition of these specific visual features to simple cognitive tasks does not appear to significantly affect performance or task-dependent cognitive load.

Meta-analysis of the effects of game types and devices on older adults-video game interaction: Implications for video game training on cognition

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.

Benefits of Higher Cardiovascular and Motor Coordinative Fitness on Driving Behavior Are Mediated by Cognitive Functioning: A Path Analysis

Driving is an important skill for older adults to maintain an independent lifestyle, and to preserve the quality of life. However, the ability to drive safely in older adults can be compromised by age-related cognitive decline. Performing an additional task during driving (e.g., adjusting the radio) increases cognitive demands and thus might additionally impair driving performance. Cognitive functioning has been shown to be positively related to physical activity/fitness such as cardiovascular and motor coordinative fitness. As such, a higher fitness level might be associated with higher cognitive resources and may therefore benefit driving performance under dual-task conditions. For the first time, the present study investigated whether this association of physical fitness and cognitive functioning causes an indirect relationship between physical fitness and dual-task driving performance through cognitive functions. Data from 120 healthy older adults (age: 69.56 ± 3.62, 53 female) were analyzed. Participants completed tests on cardiovascular fitness (cardiorespiratory capacity), motor coordinative fitness (composite score: static balance, psychomotor speed, bimanual dexterity), and cognitive functions (updating, inhibition, shifting, cognitive processing speed). Further, they performed a virtual car driving scenario where they additionally engaged in cognitively demanding tasks that were modeled after typical real-life activities during driving (typing or reasoning). Structural equation modeling (path analysis) was used to investigate whether cardiovascular and motor coordinative fitness were indirectly associated with lane keeping (i.e., variability in lateral position) and speed control (i.e., average velocity) while dual-task driving via cognitive functions. Both cardiovascular and motor coordinative fitness demonstrated the hypothesized indirect effects on dual-task driving. Motor coordinative fitness showed a significant indirect effect on lane keeping, while cardiovascular fitness demonstrated a trend-level indirect effect on speed control. Moreover, both fitness domains were positively related to different cognitive functions (processing speed and/or updating), and cognitive functions (updating or inhibition), in turn, were related to dual-task driving. These findings indicate that cognitive benefits associated with higher fitness may facilitate driving performance. Given that driving with lower cognitive capacity can result in serious consequences, this study emphasizes the importance for older adults to engage in a physically active lifestyle as it might serve as a preventive measure for driving safety.

Impact of screen size on cognitive training task performance: An HMD study

To better understand the impact of different screen sizes in cognitive training, study subjects performed an adaptive training task at three separate visual angles using a head-mounted display (HMD). Cognitive load was assessed using EEG and compared with task performance (accuracy and response time) for each condition. While previous studies found performance benefits corresponding to increased screen size in memory and learning tasks, our results suggest such benefits may only apply up to a visual angle of approximately 20°, after which increases in size become inversely correlated with task performance.

Differential effects of cognitive training modules in healthy aging and mild cognitive impairment: A comprehensive meta-analysis of randomized controlled trials

This meta-analysis was designed to compare the effectiveness of 2 cognitive training modules, single-component training, which targets 1 specific cognitive ability, versus multicomponent training, which trains multiple cognitive abilities, on both trained abilities (near transfer) and untrained abilities (far transfer) in older adults. The meta-analysis also assessed whether individual differences in mental status interacted with the extent of transfer. Eligible randomized controlled trials (215 training studies) examined the immediate effects of cognitive training in either healthy aging (HA) or mild cognitive impairment (MCI). Results yielded an overall net-gain effect size (g) for the cognitive training of 0.28 (p < .001). These effects were similar across mental status and training modules, and were significant for both near (g = 0.37) and far (g = 0.22) transfer. Although all training modules yielded significant near transfer, only a few yielded significant far transfer. Single-component training of executive functions was most effective on near and far transfer, with processing speed training improving everyday functioning. All modules of multicomponent training (specific and nonspecific) yielded significant near and far transfer, including everyday functioning. Training effects on cognition were moderated by educational attainment and number of cognitive outcomes, but only in HA. These findings suggest that, in older adults, all modules of multicomponent training are more effective in engendering near and far transfer, including everyday functioning, when compared with single-component training modules. (PsycINFO Database Record (c) 2020 APA, all rights reserved).