A controlled clinical efficacy trial of multimodal cognitive rehabilitation on episodic memory functioning in older adults with traumatic brain injury

This study investigated the effects of hierarchical cognitive training using the categorization program (CP), designed initially for adults with cognitive deficits associated with traumatic brain injury (TBI). Fifty-eight participants were included: a group of fifteen young adults with TBI (ages 18-48), another group of fifteen noninjured young adults (ages 18-50), and two groups of adults over 60 randomly assigned into the experimental group (n=14) or the control group (n=14). Following neuropsychological testing, the two young adult groups and the experimental older adult group received the CP training for 10-12 weeks. The CP training consisted of 8 levels targeting concept formation, object categorization, and decision-making abilities. Two CP tests (administered before and after the training) and three probe tasks (administered at specified intervals during the training) assessed skills relating to categorization. All treated groups showed significant improvement in their categorization performance, although younger participants (with or without TBI) demonstrated greater gains. Gains on the categorization measures were maintained by a subgroup of older adults up to four months posttraining. Implications of these findings in terms of adult cognitive learning and directions for future research on adult cognitive rehabilitation and cognitive stimulation programs are discussed.

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Effectiveness of a Multimodal Cognitive Rehabilitation Program in Older Adults With Traumatic Brain Injury

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2014.07.178 ◽

2014 ◽

Vol 95 (10) ◽

pp. e57

Author(s):

Eduardo N.M.N. Cisneros ◽

Sylvie Belleville ◽

Élaine de Guise ◽

Michelle McKerral

Keyword(s):

Older Adults ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Rehabilitation ◽

Rehabilitation Program

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The impact of multimodal cognitive rehabilitation on executive functions in older adults with traumatic brain injury

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2021.101559 ◽

2021 ◽

Vol 64 (5) ◽

pp. 101559

Author(s):

Eduardo Cisneros ◽

Véronique Beauséjour ◽

Elaine de Guise ◽

Sylvie Belleville ◽

Michelle McKerral

Keyword(s):

Older Adults ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Executive Functions ◽

Cognitive Rehabilitation ◽

The Impact

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A controlled clinical effectiveness trial of multimodal cognitive rehabilitation on episodic memory functioning in older adults with traumatic brain injury (TBI)

10.1101/2020.10.26.20216523 ◽

2020 ◽

Cited By ~ 1

Author(s):

Eduardo Cisneros ◽

Elaine de Guise ◽

Sylvie Belleville ◽

Michelle McKerral

Keyword(s):

Older Adults ◽

Episodic Memory ◽

Cognitive Rehabilitation ◽

Well Being ◽

Cognitive Intervention ◽

Psychological Well Being ◽

Memory Functioning ◽

Time Interaction ◽

The Impact ◽

Experimental Group

AbstractObjectivesThis study aimed to evaluate the impact of a multimodal cognitive intervention, the Cognitive Enrichment Program (CEP), on episodic memory in traumatic brain injured (TBI) older adults, as compared to an active control group that received usual care in the form of holistic rehabilitation.MethodsThe CEP’s Memory module consisted in memory strategies to promote encoding. Effectiveness was evaluated by psychometric tests (Face-name association, Word list recall, Text memory), while generalization was measured through self-reported questionnaires about daily memory functioning (Self-Evaluation Memory Questionnaire) and psychological well-being (Psychological General Well-Being Index). Measures were obtained before and after intervention, and six months later.ResultsBoth groups showed improvement on most measures, but the experimental group showed greater statistically significant improvement. ANCOVA mixed model repeated measures analysis showed a strong group-by-time interaction for the Face-name association test, with a large effect size. A significant group-by-time interaction was obtained on three generalization self-report measures, including increased memorization of the content of Conversations, reduced Slips of attention, and increased memory of Political & social Events, with moderate to large effect sizes. Clinically significant improvements were found for Psychological well-being in the experimental group, where 50% of participants improved to the well-being category and remained stable six months later (9/17; 53%). Also, the number of experimental participants showing severe distress before CEP training (9) was reduced after intervention (5) and remained relatively stable at 6 months.ConclusionsThe CEP is a promising cognitive rehabilitation program that showed high satisfaction in participants and that can not only improve episodic memory in terms of psychometric scores, but also in daily life situations, as well as enhance psychological well-being in older individuals having sustained a TBI.

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The impact of multimodal cognitive rehabilitation on executive functions in older adults with traumatic brain injury (TBI)

10.1101/2020.10.26.20220012 ◽

2020 ◽

Author(s):

Eduardo Cisneros ◽

Véronique Beauséjour ◽

Elaine de Guise ◽

Sylvie Belleville ◽

Michelle McKerral

Keyword(s):

Older Adults ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Active Control ◽

Cognitive Rehabilitation ◽

Daily Life ◽

Control Group ◽

Active Control Group ◽

Daily Life Activities ◽

The Impact

AbstractObjectivesThis study evaluated the impact of a multimodal cognitive rehabilitation intervention, the Cognitive Enrichment Program (CEP), on executive functioning (EF) and resumption of daily activities following traumatic brain injury (TBI) in older individuals, in comparison to an active control group having received holistic rehabilitation as usual care.MethodsThe CEP’sexecutive function module included planning, problem solving, and goal management training, as well as strategies focusing on self-awareness. Effectiveness was evaluated by psychometric tests (Modified Six Elements Task-adapted – MSET-A, D-KEFS Sorting test and Stroop four-color version), while generalization was measured through self-reported questionnaires about daily functioning (Dysexecutive Functioning Questionnaire – DEX, Forsaken daily life activities). Measures were obtained before and after intervention, and six months later.ResultsANCOVA results showed significant group-by-time interactions on Tackling the 6 subtasks and Avoiding rule-breaking measures of the MSET-A, with moderate effect sizes. Despite improvements in Sorting and Stroop scores, there were no group-by-time interaction on these measures. DEX generalization measure showed a significant reduction in patient/significant other difference on the Executive Cognition subscale. There was a reduction in the number of Forsaken daily life activities in the experimental group compared to controls which was not significant immediately after CEP, but that was significant six months later.ConclusionsOur study shows that older adults with TBI can improve their executive functioning with a positive impact on everyday activities after receiving multimodal cognitive training compared to an active control group.

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Cognitive control constrains memory attributions

Behavioral and Brain Sciences ◽

10.1017/s0140525x19001869 ◽

2019 ◽

Vol 42 ◽

Author(s):

Colleen M. Kelley ◽

Larry L. Jacoby

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

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