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Verty LV, Mellah S, Maltezos S, Boujut A, Lussier M, Bherer L, Belleville S. Youth-like brain activation linked with greater cognitive training gains in older adults: Insights from the ACTOP study. Cortex 2024; 176:221-233. [PMID: 38805784 DOI: 10.1016/j.cortex.2024.04.013] [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: 11/24/2023] [Revised: 03/07/2024] [Accepted: 04/23/2024] [Indexed: 05/30/2024]
Abstract
This study investigates the relationship between inter-individual neurofunctional differences in older adults and cognitive training efficacy, with a specific focus on the association between youth-like task-related brain activation and improvements in working memory (WM) training. The data is part of the Attentional Control Training for Older People (ACTOP) study, 30 older adults completed 12 half-hour WM training sessions. The WM performance slope, assessed at the conclusion of sessions 1 through 6 and sessions 7 to 12, determined early- and late-stage training gains, respectively. Transfer measures were taken before (PRE), midway (MID), and after (POST) training, and the differences in MID-PRE and POST-MID on transfer tasks were used to determine early- and late-stage transfer effects, respectively. The Goodness of Fit (GOF) metric was used to quantify the similarity between each older adult's activation pattern, as measured with functional magnetic resonance imaging (fMRI), to that of a group of younger adults. GOF scores were calculated for activation during low-load (1-0back) and high-load (2-0back) N-back tasks. The results indicated that larger GOF scores in the low-load condition were associated with greater training gains in both the early and late learning stages, and that larger GOF scores in the high-load condition were associated with greater training gains during the late-stage. These findings suggest that a youth-like brain activation pattern in older adults is associated with greater cognitive training benefits, underscoring the role of inter-individual neurofunctional differences to account for variations in training outcomes among older adults. TRIAL REGISTRATION: ClinicalTrials.gov NCT03532113; https://clinicaltrials.gov/ct2/show/NCT03532113.
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Affiliation(s)
- Lynn Valeyry Verty
- Research Center, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Samira Mellah
- Research Center, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Samantha Maltezos
- Research Center, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Arnaud Boujut
- Research Center, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada; Université de Limoges, HAVAE - UR20217, Limoges, France; 3iL Ingénieurs, Limoges, France
| | - Maxime Lussier
- Research Center, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Louis Bherer
- Research Center, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Montreal Heart Institute, Montreal, QC, Canada
| | - Sylvie Belleville
- Research Center, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
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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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Montejo Carrasco P, Montenegro-Peña M, Prada Crespo D, Rodríguez Rojo I, Barabash Bustelo A, Montejo Rubio B, Marcos Dolado A, Maestú Unturbe F, Delgado Losada ML. APOE genotype, hippocampal volume, and cognitive reserve predict improvement by cognitive training in older adults without dementia: a randomized controlled trial. Cogn Process 2024:10.1007/s10339-024-01202-3. [PMID: 38896211 DOI: 10.1007/s10339-024-01202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
Cognitive training (CT) programs aim to improve cognitive performance and impede its decline. Thus, defining the characteristics of individuals who can benefit from these interventions is essential. Our objectives were to assess if the cognitive reserve (CR), APOE genotype (e4 carriers/non-carriers) and/or hippocampal volume might predict the effectiveness of a CT program. Participants were older adults without dementia (n = 226), randomized into parallel experimental and control groups. The assessment consisted of a neuropsychological protocol and additional data regarding total intracranial, gray matter, left/right hippocampus volume; APOE genotype; and Cognitive Reserve (CR). The intervention involved multifactorial CT (30 sessions, 90 min each), with an evaluation pre- and post-training (at six months); the control group simply following the center's routine activities. The primary outcome measures were the change in cognitive performance and the predictors of change. The results show that APOE-e4 non-carriers (79.1%) with a larger left hippocampal volume achieved better gains in semantic verbal fluency (R2 = .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R2 = .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R2 = .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R2 = .087). In conclusion, besides the program itself, the effectiveness of CT depends on age, biological factors like genotype and brain volume, and CR. Thus, to achieve better results through a CT, it is essential to consider the different characteristics of the participants, including genetic factors.Trial registration: Trial retrospectively registered on January 29th, 2020-(ClinicalTrials.gov -NCT04245579).
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Affiliation(s)
- Pedro Montejo Carrasco
- Centre for the Prevention of Cognitive Impairment, Madrid Salud, Madrid City Council, Montesa 22 Building B, 28006, Madrid, Spain
| | - Mercedes Montenegro-Peña
- Centre for the Prevention of Cognitive Impairment, Madrid Salud, Madrid City Council, Montesa 22 Building B, 28006, Madrid, Spain.
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain.
| | - David Prada Crespo
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain
- Department of Psychology, Faculty of Biomedical and Health Sciences, European University, Madrid, Spain
| | - Inmaculada Rodríguez Rojo
- Center for Cognitive and Computational Neuroscience, Complutense University, Madrid, Spain
- Department of Nursing and Physiotherapy, Alcalá University, Madrid, Spain
| | - Ana Barabash Bustelo
- Endocrinology and Nutrition Department, San Carlos Clinic Hospital, Health Research Institute of the San Carlos Clinic Hospital (IdISSC), Madrid, Spain
- Department of Medicine II, Faculty of Medicine, Complutense University, Madrid, Spain
| | | | - Alberto Marcos Dolado
- Department of Neurology, San Carlos Clinic Hospital, Health Research Institute of the San Carlos Clinic Hospital (IdISSC), Madrid, Spain
| | - Fernando Maestú Unturbe
- Department of Experimental Psychology, Faculty of Psychology, Complutense University, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University, Madrid, Spain
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Zamarreño P, Mateos PM, Valentín A. Working memory training improves episodic memory in older people: transfer based on controlled retrieval processes. Front Psychol 2024; 15:1314483. [PMID: 38572199 PMCID: PMC10987720 DOI: 10.3389/fpsyg.2024.1314483] [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: 10/17/2023] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction The results of working memory (WM) training to improve episodic memory in older people are inconsistent. This inconsistency could be due to the fact that the episodic memory tests used do not share the same cognitive resources as the trained WM task. The aim of this study was to assess whether performance on an episodic memory test will improve only when this test requires controlled processes of retrieval of information from secondary memory or recollection, similar to the processes exercised during WM training. Method Fifty-five people over 60 years of age participated in the study: 27 were randomly assigned to the experimental group (EG) and the rest to the control group (CG). The EG was trained in complex span tasks. Before and after training, both groups were tested on episodic memory tests (a verbal and a visuospatial recognition test) and WM span tasks (reading, digit and spatial location). Results ANOVAs revealed a greater improvement of recollection estimates in the EG than in the CG for both verbal recognition (p = 0.023) and visuospatial recognition (p = 0.014). Discussion Our results provide support for a cognitive mechanism whose shared presence favored transfer from training on a WM task to a test of episodic memory. Consistent with our predictions, training on complex span tasks improved performance on recognition tests only when recall required a controlled search process in secondary memory, or recollection. We therefore stress the importance of identifying other cognitive resources that are susceptible to transfer from a training task to other untrained tasks. A better understanding of the phenomenon of transfer is crucial for the design of increasingly effective intervention programs for older people.
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Esmailzade Moghimi S, Mohammadi F, Yadegari F, Dehghan M, Hojjati SMM, Saadat P, Geraili Z, Alizadeh M. Verbal and oral apraxia in patients with acute stroke: Frequency, relationship, and some risk factors. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:97-108. [PMID: 34726969 DOI: 10.1080/23279095.2021.1993225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Verbal and oral apraxia are two possible consequences of stroke. It seems that there are not sufficient studies regarding the frequency of these disorders. This study aimed to evaluate the frequency of Verbal and oral apraxia. In addition, the relationship between apraxia and some variables such as age, gender, and education, as well as the relationship between types of apraxia with each other, and damaged areas of the brain in apraxia of the oral system in Persian-speaking patients with stroke were studied. In this descriptive-analytical study, 42 patients participated using the convenient sampling method. Verbal and oral apraxia were assessed using the oral and verbal apraxia tasks for adults test. Data were analyzed using independent t-test, Chi-square, and Fisher's exact test. The frequency of patients with oral apraxia was 35.7%, those with verbal apraxia was 2.3%, and the combination of both verbal and oral apraxia was 4.7%. People with apraxia were significantly older than those without apraxia. There was not any significant relationship between apraxia and gender, apraxia and education, and oral apraxia with verbal apraxia (p < 0.05). The present study's findings showed the high frequency of post-stroke apraxia and the high rate of its incidence with age.
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Affiliation(s)
| | - Fatemeh Mohammadi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Fariba Yadegari
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Dehghan
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
| | | | - Payam Saadat
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Neurology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Geraili
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Alizadeh
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
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Wang D, Rushton S, Ledbetter L, Graton M, Ramos K, Hendrix CC. Factors associated with memory of informal caregivers: A scoping review protocol. PLoS One 2024; 19:e0295449. [PMID: 38277350 PMCID: PMC10817195 DOI: 10.1371/journal.pone.0295449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/21/2023] [Indexed: 01/28/2024] Open
Abstract
The ability to retain and remember information (memory) is essential to caregiving tasks. There is evidence that caregivers are at greater risk for experiencing deteriorations in cognitive status than non-caregivers, especially memory; however, we have a limited understanding of factors that are related to changes in caregiver memory. This scoping review intends to comprehensively map factors related to caregiver memory reported in the literature within the chronic caregiving context. Specific aims include (1) identifying factors related to caregiver memory; (2) examining how caregiver memory has been measured; and (3) describing changes in caregiver memory during their caregiving period. This review will be conducted following Arksey and O'Malley's framework and reported using the PRISMA guidelines for Scoping Reviews (PRISMA-ScR). Studies will be included if (1) the studies focus on home-based unpaid long term family caregiving; (2) study participants (patients), of any age, have one (or more) chronic illness or disability and receive care from a caregiver for 6 months or more; (3) caregivers are adults (> = 18 years of age). Any chronic disease or condition will be included. The search will encompass gray literature and peer-reviewed literature in MEDLINE (via Ovid), CINAHL Plus with Full Text (via EBSCOhost), Embase (via Elsevier), APA PsycINFO (via EBSCOhost), Sociology Source Ultimate (via EBSCOhost), and ProQuest Dissertations and Theses Global. Data extraction will include specific details about the participants, concept, context, study methods, and key caregiver-related findings. The Caregiver Health Model will provide a framework to categorize factors that impact caregivers' memory including caregiver health promotion activities, caregiver attitudes and beliefs, caregiver task, and caregiver needs. Factors that do not fall into the Caregiver Health Model domains will be organized by emerging themes.
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Affiliation(s)
- Dingyue Wang
- School of Nursing, Duke University, Durham, NC, United States of America
| | - Sharron Rushton
- School of Nursing, Duke University, Durham, NC, United States of America
| | - Leila Ledbetter
- Duke University Medical Center & Archives, School of Medicine, Durham, NC, United States of America
| | - Margaret Graton
- Duke University Medical Center & Archives, School of Medicine, Durham, NC, United States of America
| | - Kimberly Ramos
- Des Moines University, West Des Moines, IA, United States of America
| | - Cristina C. Hendrix
- School of Nursing, Duke University, Durham, NC, United States of America
- GRECC Durham Veterans Affairs Medical Center, Durham, NC, United States of America
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Borella E, Sella E, Simonetto A, Bellorio N, Lenti G, Taconnat L, Carbone E. Effects of Strategy-Based Memory Training for Older Adults: Do Booster Sessions Prompt Long-Term Benefits? Brain Sci 2023; 13:1301. [PMID: 37759902 PMCID: PMC10526930 DOI: 10.3390/brainsci13091301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
This study examined the efficacy of a strategy-based memory training for older adults at short- and long-term with two (5- and 11 months) follow-ups. We also explored whether booster sessions (additional training before the first follow-up) facilitated the maintenance of benefits. Thirty-three older adults received a training based on the teaching of different effective memory strategies. One group completed three booster sessions before the 5 months follow-up. Training gains were examined using a word-list and a face-surname association recall tasks, and transfer effects with a grocery-word list (GL) recall task, a working memory (WM) measure, and a perceived memory functioning questionnaire. Training gains and transfer effects to the WM measure emerged and were maintained up to the second follow-up. No benefits for the GL and perceived memory functioning were found. The "boosted" group had only a slight advantage-in one of the transfer tasks-as shown by effect sizes. This pilot study confirms the efficacy of strategy-based memory training in supporting older adults' memory performance up to 11 months since training completion. However, booster sessions seem not to make a clear difference in prompting long-lasting benefits. Training features capable of fostering generalized, prolonged effects are worth investigating.
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Affiliation(s)
- Erika Borella
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Enrico Sella
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Anna Simonetto
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Nicola Bellorio
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Graziana Lenti
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
| | - Laurence Taconnat
- Université de Poitiers et Centre de Recherches sur la Cognition et l’Apprentissage, Université de Tours, UMR-CNRS 7295, 37000 Tours, France;
| | - Elena Carbone
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (E.B.); (E.S.)
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8
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Jaeggi SM, Weaver AN, Carbone E, Trane FE, Smith-Peirce RN, Buschkuehl M, Flueckiger C, Carlson M, Jonides J, Borella E. EngAge - A metacognitive intervention to supplement working memory training: A feasibility study in older adults. AGING BRAIN 2023; 4:100083. [PMID: 38098966 PMCID: PMC10719574 DOI: 10.1016/j.nbas.2023.100083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/31/2023] [Accepted: 06/15/2023] [Indexed: 12/17/2023] Open
Abstract
Working Memory (WM) training has shown promise in supporting cognitive functioning in older adult populations, but effects that generalize beyond the trained task have been inconsistent. Targeting cognitive processes in isolation might be a limiting factor given that metacognitive and motivational factors have been shown to impact older adults' engagement with challenging cognitive activities, such as WM training. The current feasibility study implemented a novel metacognitive intervention in conjunction with WM training in older adults and examined its potential amplifying short- and long-term effects on cognitive and self-report outcomes as compared to WM or active control training alone. One-hundred and nineteen older adults completed a cognitive training over the course of 20 sessions at home. The cognitive training targeted either WM or general knowledge. In addition, one of the WM training groups completed a metacognitive program via group seminars. We tested for group differences in WM, inhibitory control, and episodic memory, and we assessed participants' perceived self-efficacy and everyday memory failures. At post-test, we replicated earlier work by demonstrating that participants who completed the WM intervention outperformed the active control group in non-trained WM measures, and to some extent, in inhibitory control. However, we found no evidence that the supplemental metacognitive program led to benefits over and above the WM intervention. Nonetheless, we conclude that our metacognitive program is a step in the right direction given the tentative long-term effects and participants' positive feedback, but more longitudinal data with larger sample sizes are needed to confirm these early findings.
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Affiliation(s)
| | | | - Elena Carbone
- Department of General Psychology, University of Padova, Italy
| | | | | | | | | | | | | | - Erika Borella
- Department of General Psychology, University of Padova, Italy
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Bonnechère B, Klass M. Cognitive Computerized Training for Older Adults and Patients with Neurological Disorders: Do the Amount and Training Modality Count? An Umbrella Meta-Regression Analysis. Games Health J 2023; 12:100-117. [PMID: 36920851 DOI: 10.1089/g4h.2022.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Numerous applications have been created to train cognition and challenge the brain, a process known as computerized cognitive training (CCT). Despite potential positive results, important questions remain unresolved: the appropriate training duration, the efficacy of CCT depending on its type (commercial or developed in-house for the rehabilitation of specific patients) and delivery mode (at-home or on-site), and the patients most likely to benefit such intervention. This study aims to perform an umbrella meta-analysis and meta-regression to determine if the type of CCT, the delivery mode, the amount of training, and participants' age at inclusion influence the improvement of the cognitive function. To do so, we performed a umbrella meta-analysis. One hundred studies were included in this analysis representing 6407 participants. Statistical improvements were found for the different conditions after the training. We do not find statistical difference between the type of intervention or the delivery mode. No dose-response relationship between the total amount of training and the improvement of cognitive functions was found. CCT is effective in improving cognitive function in patients suffering from neurological conditions and in healthy aging. There is therefore an urgent need for health care systems to recognize its therapeutic potential and to evaluate at a larger scale their integration into the clinical pipeline as preventive and rehabilitation tool.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.,Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Malgorzata Klass
- Laboratory of Applied Biology and Neurophysiology, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
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Ben Izhak S, Lavidor M. Strategy and Core Cognitive Training Effects on Working Memory Performance: A Systematic Review and Meta-Analysis. JOURNAL OF COGNITION AND DEVELOPMENT 2023. [DOI: 10.1080/15248372.2023.2172413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Shachar Ben Izhak
- Department of Psychology, and the Gonda Brain Research Center, Bar Ilan University
| | - Michal Lavidor
- Department of Psychology, and the Gonda Brain Research Center, Bar Ilan University
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Sella E, Carbone E, Vincenzi M, Toffalini E, Borella E. Efficacy of memory training interventions targeting metacognition for older adults: a systematic review and meta-analysis. Aging Ment Health 2022; 27:674-694. [PMID: 36218025 DOI: 10.1080/13607863.2022.2122931] [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] [Indexed: 11/01/2022]
Abstract
OBJECTIVES This review examined the evidence about training interventions targeting metacognition in improving memory and cognitive performance, metacognitive functioning, and well-being in healthy older adults. METHODS Studies were identified in the PsycInfo, PubMed, and Scopus databases. The risk of bias was assessed using tools based on the Joanna Briggs criteria. The data were meta-analyzed using random effects models for those training targeting metacognition alone (metacognitive training) or combined with memory strategy training (strategic metacognitive training). RESULTS Out of the 3,487 articles first identified, 25 studies were eligible for our review (N = 1,768 older adults; mean age range: 64-85 years). Metacognitive training and strategic metacognitive training elicited improvements in memory (d = 0.52 [95% CI: 0.19; 0.84], and d = 0.44 [95% CI: 0.29; 0.58], respectively), metacognitive beliefs (d = 0.58 [95% CI: 0.23; 0.93], and d = 48 [95% CI: 0.28; 0.69], respectively), strategy use (d = 0.98 [95% CI: 0.46; 1.49] and 0.87 [95% CI: 0.14; 1.61], respectively), and memory self-efficacy (d = 0.08 [95% CI: -0.39; 0.56] and 0.55 [95% CI: 0.36; 0.75], respectively). Strategic metacognitive training also improved well-being (d = 0.21 [95% CI: 0.07; 0.35]). CONCLUSION Interventions targeting metacognition (alone or combined with memory strategy training) have the potential to support older adults' memory and metacognitive functioning. The methodological quality of most studies on the topic was often limited, however. Furthermore, well-designed studies needed to confirm the benefits of such interventions in older age.
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Affiliation(s)
- Enrico Sella
- Department of General Psychology, University of Padova, Padova, Italy
| | - Elena Carbone
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Enrico Toffalini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Borella
- Department of General Psychology, University of Padova, Padova, Italy
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Training attentive individuation leads to visuo-spatial working memory improvement in low-performing older adults: An online study. Atten Percept Psychophys 2022; 84:2507-2518. [PMID: 36192602 DOI: 10.3758/s13414-022-02580-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/08/2022]
Abstract
Cognitive decrements are typical of physiological aging. Among these age-related cognitive changes, visuo-spatial working memory (vWM) decline has a prominent role due to its effects on other cognitive functions and daily routines. To reinforce vWM in the aging population, several cognitive training interventions have been developed in the past years. Given that vWM functioning depends (at least partially) on the efficiency of attention selection of the relevant objects, in the present study we implemented a short (five sessions), online intervention that primarily trained attentive individuation of target items and tested training effects on a vWM task. Attention training effects were compared with practice (i.e., a group that repeatedly performed the same vWM task) and test-retest effects (i.e., a passive group). After the training, the results showed attention training effects of the same magnitude as practice effects, confirming that the enhancement of attentive individuation has a positive cascade influence on maintaining items in vWM. Moreover, training and practice effects were only evident in low-performing older adults. Thus, interindividual differences at baseline crucially contribute to training outcomes and are a fundamental factor to be accounted for in the implementation of cognitive training protocols.
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Agassi OD, Hertz U, Shani R, Derakshan N, Wiener A, Okon-Singer H. Using clustering algorithms to examine the association between working memory training trajectories and therapeutic outcomes among psychiatric and healthy populations. PSYCHOLOGICAL RESEARCH 2022; 87:1389-1400. [DOI: 10.1007/s00426-022-01728-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/13/2022] [Indexed: 10/14/2022]
Abstract
AbstractWorking memory (WM) training has gained interest due to its potential to enhance cognitive functioning and reduce symptoms of mental disorders. Nevertheless, inconsistent results suggest that individual differences may have an impact on training efficacy. This study examined whether individual differences in training performance can predict therapeutic outcomes of WM training, measured as changes in anxiety and depression symptoms in sub-clinical and healthy populations. The study also investigated the association between cognitive abilities at baseline and different training improvement trajectories. Ninety-six participants (50 females, mean age = 27.67, SD = 8.84) were trained using the same WM training task (duration ranged between 7 to 15 sessions). An algorithm was then used to cluster them based on their learning trajectories. We found three main WM training trajectories, which in turn were related to changes in anxiety symptoms following the training. Additionally, executive function abilities at baseline predicted training trajectories. These findings highlight the potential for using clustering algorithms to reveal the benefits of cognitive training to alleviate maladaptive psychological symptoms.
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14
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Rotenberg S, Dawson DR. Characterizing Cognition in Everyday Life of Older Adults With Subjective Cognitive Decline. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:269-276. [PMID: 35499254 PMCID: PMC9459355 DOI: 10.1177/15394492221093310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Subjective cognitive decline (SCD), the subjective experience of
worsening cognition with no objective cognitive impairment, poses a
heightened risk for dementia. This study aimed to characterize
cognition in the everyday life of people with SCD, is crucial for
understanding and preventing further functional and cognitive decline.
One hundred and thirty-five older adults (age 70.7±6.7) with SCD were
assessed using functional-cognition measures: Multifactorial Memory
Questionnaire (MMQ), Behavior Rating Inventory of Executive
Function–Adult version (BRIEF-A), and Multiple Errands Test (MET). The
resulted showed that older adults with SCD reported lower memory
satisfaction (Hedges’s g = 0.41) on the MMQ, and
worse metacognition on the BRIEF-A (Hedges’s g =
0.63) compared with published normative data. They completed an
average of only 6/12 required tasks on the MET. The findings show
functional difficulties related to SCD and inform the development of
occupational therapy intervention for this population.
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Affiliation(s)
- Shlomit Rotenberg
- University of Toronto, Ontario, Canada
- Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Deirdre R. Dawson
- University of Toronto, Ontario, Canada
- Baycrest Health Sciences, Toronto, Ontario, Canada
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Ophey A, Wenzel J, Paul R, Giehl K, Rehberg S, Eggers C, Reker P, van Eimeren T, Kalbe E, Kambeitz-Ilankovic L. Cognitive Performance and Learning Parameters Predict Response to Working Memory Training in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:2235-2247. [PMID: 36120792 PMCID: PMC9661332 DOI: 10.3233/jpd-223448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Working memory (WM) training (WMT) is a popular intervention approach against cognitive decline in patients with Parkinson's disease (PD). However, heterogeneity in WM responsiveness suggests that WMT may not be equally efficient for all patients. OBJECTIVE The present study aims to evaluate a multivariate model to predict post-intervention verbal WM in patients with PD using a supervised machine learning approach. We test the predictive potential of novel learning parameters derived from the WMT and compare their predictiveness to other more commonly used domains including demographic, clinical, and cognitive data. METHODS 37 patients with PD (age: 64.09±8.56, 48.6% female, 94.7% Hoehn & Yahr stage 2) participated in a 5-week WMT. Four random forest regression models including 1) cognitive variables only, 2) learning parameters only, 3) both cognitive and learning variables, and 4) the entire set of variables (with additional demographic and clinical data, 'all' model), were built to predict immediate and 3-month-follow-up WM. RESULT The 'all' model predicted verbal WM with the lowest root mean square error (RMSE) compared to the other models, at both immediate (RMSE = 0.184; 95% -CI=[0.184;0.185]) and 3-month follow-up (RMSE = 0.216; 95% -CI=[0.215;0.217]). Cognitive baseline parameters were among the most important predictors in the 'all' model. The model combining cognitive and learning parameters significantly outperformed the model solely based on cognitive variables. CONCLUSION Commonly assessed demographic, clinical, and cognitive variables provide robust prediction of response to WMT. Nonetheless, inclusion of training-inherent learning parameters further boosts precision of prediction models which in turn may augment training benefits following cognitive interventions in patients with PD.
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Affiliation(s)
- Anja Ophey
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Cologne, Germany
| | - Julian Wenzel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | - Riya Paul
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Kathrin Giehl
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
- Research Centre Jülich, Institute of Neuroscience and Medicine (INM-2), Jülich, Germany
| | - Sarah Rehberg
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Cologne, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Universities of Marburg and Gießen, Marburg, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop, Bottrop, Germany
| | - Paul Reker
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Thilo van Eimeren
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Elke Kalbe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
- Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Munich, Germany
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Effectiveness of Cognitive Stimulation Personalized by the Preexisting Cognitive Level in Older Adults. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Ophey A, Rehberg S, Giehl K, Eggers C, Reker P, van Eimeren T, Kalbe E. Predicting Working Memory Training Responsiveness in Parkinson's Disease: Both "System Hardware" and Room for Improvement Are Needed. Neurorehabil Neural Repair 2021; 35:117-130. [PMID: 33410387 DOI: 10.1177/1545968320981956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background. Patients with Parkinson's disease (PD) are highly vulnerable to develop cognitive dysfunctions, and the mitigating potential of early cognitive training (CT) is increasingly recognized. Predictors of CT responsiveness, which could help to tailor interventions individually, have rarely been studied in PD. This study aimed to examine individual characteristics of patients with PD associated with responsiveness to targeted working memory training (WMT). Methods. Data of 75 patients with PD (age: 63.99 ± 9.74 years, 93% Hoehn & Yahr stage 2) without cognitive dysfunctions from a randomized controlled trial were analyzed using structural equation modeling. Latent change score models with and without covariates were estimated and compared between the WMT group (n = 37), who participated in a 5-week adaptive WMT, and a waiting list control group (n = 38). Results. Latent change score models yielded adequate model fit (χ2-test p > .05, SRMR ≤ .08, CFI ≥ .95). For the near-transfer working memory composite, lower baseline performance, younger age, higher education, and higher fluid intelligence were found to significantly predict higher latent change scores in the WMT group, but not in the control group. For the far-transfer executive function composite, higher self-efficacy expectancy tended to significantly predict larger latent change scores. Conclusions. The identified associations between individual characteristics and WMT responsiveness indicate that there has to be room for improvement (e.g., lower baseline performance) and also sufficient "hardware" (e.g., younger age, higher intelligence) to benefit in training-related cognitive plasticity. Our findings are discussed within the compensation versus magnification account. They need to be replicated by methodological high-quality research applying advanced statistical methods with larger samples.
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Affiliation(s)
| | | | | | - Carsten Eggers
- University Hospital of Marburg, Marburg, Germany.,Universities of Marburg and Gießen, Marburg, Germany
| | | | - Thilo van Eimeren
- University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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